Hospital Bills Step 1

I've talked with so many people since the release of Cover Me about their own insurance troubles. The Affordable Care Act will take care of some of the most egregious insurance agency abuses. Unfortunately, since we still live with a private and for-profit system, health reform has not changed the reality of dealing with the paperwork and the expense of being sick. The reforms were absolutely vital, and we need more.

But in the interest of being practical, I also want to share some tricks about what to do when you have a hospital bill to deal with.

Step 1 happens before you even leave the hospital. If you are admitted, you should ask the nurse to send a social worker to talk to you, if one is not sent up to your room. If there is no hospital social worker available, have a friend or family member go down to the billing office.

Your goal here is to request a "charity care" application. This sounds like you're applying for welfare or that you're indigent. Neither of those situations are anything to be ashamed of, but the term "charity care" can make many people feel like financial assistance at the hospital is not for them. This is not true, and nothing to be ashamed of. The hospital receives tax breaks for its financial help, and what is a tiny drop in the bucket to a hospital's budget can be the difference between financial health and bankruptcy for an individual.

What is charity care? Charity care is simply an assessment the hospital does about your ability to pay. They will ask for a tax return, a recent pay stub, and/or a list of your assets. Then, the billing office determines by a formula what percentage of your bill you should be responsible for paying.

The rest of the total you owe disappears.

Really, it's that simple. If you need help, the first step is to just ask. The barrier to this service is that hospital staff are overworked and do not have enough chaplains or social workers to see all the patients. Not everyone gets told about this absolutely vital service. And then if they do, some patients get a pride attack. You can pay the whole bill if you feel like it's your duty to the almighty dollar. But if you had to stay overnight to be observed for stomach pains that went away on their own and you don't have thousands of dollars to pay for that, the hospital sometimes actually understands.

Wow. Step 2: The application.

Timeline for Health Reforms

The Kaiser Foundation has a health reform timeline that breaks down when the various changes will go into effect for the Affordable Care Act. One of the nicest things about this is that it includes updates about the provisions, which are implemented and which are still to come, and also includes color-coded logos for each type of reform. It makes the fine print much easier to digest!

Brandy in Vidalia

I just put a dollar in a clear plastic bucket at the grocery store checkout. The sight is so common that I've almost stopped seeing it--I grew up with that sort of thing in my peripheral vision, glance left or right while paying for gas, and there is the latest horrible tragedy. Usually it's a bucket in a grocery store with a picture of a sick child, and you know that the parents don't have time to focus on their child's health. Instead, they have distraction, and more stress, and the worry about money to draw their attention away from what really matters.

This time, Brandy in Vidalia, Georgia, was in a serious car accident and needs help with medical costs.

These buckets sum up the idea "the banality of evil." I imagine that visitors from other countries might find it barbaric that someone with an ill child would have to take the time to gather buckets, make signs, tell the story over and over again to cashiers, drive from gas station to grocery store, to collect change. And the change can't ever begin to make a dent in medical costs for a serious illness.

I often put money in. Sometimes I don't because the quarter or dollar I have in change feels so inadequate. Every time I see one, though, I'm shaken to the core by what we can become accustomed to as normal.