No Health Insurance and Big Medical Bills: Now there’s Help for Illinois Residents

Recently we got a letter from our reader Karen J., where she describes the problem that she had to face and searches for possible ways out.

“I recently had a very bad experience with the health care industry and I don’t know who I can turn to for advice.

I work as a home health care nurse. Recently after a series of stressful experiences I suffered an enormous amount of fatigue and as a result I “passed out” at a client’s house. The client panicked and called 911. I have sleep apnea, and so it was very difficult for the paramedic to revive me. I started coming around, but because of the client’s anxiety, the decision was made to transport me to a nearby emergency room.

In the emergency room I was slowly regaining consciousness, but that wasn’t allowed to happen. Instead, I was sedated and intubated and transferred to an intensive care unit where I was submitted to many tests while I was kept unconscious.

All tests came out negative, so I never had a diagnosis. I was discharged 5 days later. Now I’m receiving medical bills which I will never be able to pay because I have no health insurance. This is extremely distressing to me because there was never any need for me to be hospitalized at all. I would have been fine if it were not for being, as I call it, medically kidnapped.

I have spoken with attorneys and they don’t see any way around this. Do you or anyone in your organization have any suggestions for me? Thank you for reading my story.

Karen J.”

Here’s a short list of helpful suggestions for folks like Karen J. to evaluate and possibly utilize:

• Know your rights. First it is good to know what rights as a patient you have. What information medical institution is required to present you with and what are your rights when it comes to choose the treatment options. A good start may be Wikipedia article: U.S. Patients’ Bill of Rights.
• Know latest laws. As far as it gets to Illinois residents, recently Attorney General Lisa Madigan introduced a new law that caps hospital bills and offers significant discounts for uninsured patients in Illinois. The new law has been effective since April 1, 2009.

The Hospital Uninsured Patient Discount Act significantly reduces charges for uninsured Illinois patients and prevents discriminatory pricing based on a patient’s insurance status. Currently, uninsured patients are charged dramatically higher rates for hospital services than insured patients, whose rates are negotiated by insurance companies. On average, hospitals charge uninsured patients rates that exceed 200 percent over cost.

Since the law has gone into effect on April 1, hospital charges to the eligible uninsured can no longer exceed the costs of the services plus 35 percent. The new law also places an annual cap on the amount that hospitals can collect from eligible uninsured patients, limiting the total amount to 25 percent of the patient’s family income during a 12-month period.

You can read more at Hospitals: landmark law creates equity in uninsured hospital billing rates.

• Get help from non-profit organizations. A good place to start is Illinois Legal Aid web site. Illinois Legal Aid organization provides information to help Illinois residents resolve their legal problems. This is page dedicated to Deal with Hospital Bills.
• File  a complaint. You can file a complaint at consumer reporting web sites such as Ripoff Report.
• Hire lawyers. Get Hospital Bill Auditing Service from the professionals. Some of the companies charge only a percentage of the amount by which they get your bill reduced. Sounds like win – win situation. Usually their websites provide a lot of useful information about patients’ billing rights under federal law and hospital billing practices, step by step guides for the patients.

As a professional worker in a hospital, I certainly hope this information is helpful for Karen J. and folks like her struggling with trying to provide themselves with affordable out of pocket medical care. I certainly understand the issues people are facing today in regards to the cost of their care.

If possible, it is a good idea to take out a simple medical insurance plan that covers only major medical coverage in the event of a hospitalization, as in Karen J.’s case. Some of these plans can be surprisingly affordable (around the price you’d pay for cable television every month). The downside is that a plan like this would not cover any doctor visits, well care, or prescription meds. The deductables are often quite high (up to $10,000) but when a long stay in the hospital is necessary the coverage can be 100% depending on your policy. And this could make a world of difference, especially in the case of a sudden illness or injury.

Update:

There is another good article about this issue at SmartPlanet: Is that medical bill your final offer?.

Your comments and suggestions are welcome.