Random question about medical bills

TazziRN, RN · Jun 1, 2007

If he doesn't pay he'll be hearing from collection agencies soon. Health care in this country is not free, not even to people on aid programs. If he has no financial means I don't think he can file for bankruptcy.

Kanani_Ikike · Jun 1, 2007

Hi fellow nurses!
I have a random question, but it has really been bothering me lately. Heres the story; I had a friend in high school who took off some years, and recently came to the same university I graduated from. We still live in the area, and he really needed to take summer classes to keep his scholarships. We let him stay with us since he had no financial means whatsoever. Anyway, last week he informed me he has NO HEALTH INSURANCE!!! Normally, I wouldnt be so upset, but he has Type 1 diabetes! He has racked up over $40,000 in medical debt. I am trying to convince him that he NEEDS medical insurance, and that he DOES have to pay the hospital back (for some reason he thinks he doesnt) Could someone explain to me the legality behind paying back that kind of debt. What happens if you file for bankruptcy over medical bills? I want to get it through his thick skull that he needs some sort of health insurance, and I just cant seem to find any facts while surfing. I am just a GN, so I really dont know much about that kind of stuff. Anyway, I guess I really care about this kid and I want him to understand how important regular healthcare is. Damn this caring nursing nature. lol! Thanks to anyone for any help you can give me!

Wow! You're friend really does need health insurance. But, I don't know if he would be able to get it now. Being that he has a pre-existing condition, the major insurance companies have the nerve to discriminate against people with them. I think it really is bad that they are allowed to do that. I think that health insurance should be a right, not a privilege. I don't know if he would qualify for state medicaid or not. But, I do know that Type I diabetes is nothing to wink at. He could get really sick and even become blind or lose both kidneys. Type II diabetes is bad, but he needs to be on insulin, simply put, if he has Type I diabetes. Is he doing at least that?

Poor thing. He's just clueless. But I commend you on loving him so much to try to get help for him. He is blessed to have a friend like you. Good luck with this situation. Maybe you can scare him with some statistics about Type I diabetes. That may help. Best wishes.

PiPhi2004 · Jun 1, 2007

Thanks so much for the advice! He cannot get medicaid because he owns a house (inheirited) and has too much money in assets. He does take insulin, but I have to constantly remind him about it. His diet is not too great, but I try to make nutritious foods for dinner so that he can have something good to eat and we only buy diet sodas and I try to make desserts with no sugar. He never meets with an endocrinologist, and another thing, his dental care is HORRENDOUS!! (Im sure you all know what dental care does to diabetes) I asked him where his toothbrush was A WEEK AFTER LIVING WITH US and he told me "I dont have one." I ran to Giant Eagle and bought him one and MADE him use it. Its just a bad bad situation.

Altra, BSN, RN · Jun 1, 2007

Your friend is most definitely financially responsible for all medical bills he has acquired in adulthood.

(Is it possible he's on Medicaid but doesn't want you or others to know ...?)

Does he check his blood sugar? Paying for testing supplies and insulin out-of-pocket would be very expensive, very quickly.

If your friend is truly without medicaid, without a PCP and without insulin, he should contact a county or state agency immediately to apply for medical assistance. This will not alleviate debt he has already acquired, but will start the (lengthy) process rolling so that he survives long enough to fix this mess. He should also contact the hospital billing department to ask for some kind of sliding scale fees and payment arrangements, so that he has some hope of salvaging his credit.

Altra, BSN, RN · Jun 1, 2007

Thanks so much for the advice! He cannot get medicaid because he owns a house (inheirited) and has too much money in assets. He does take insulin, but I have to constantly remind him about it. His diet is not too great, but I try to make nutritious foods for dinner so that he can have something good to eat and we only buy diet sodas and I try to make desserts with no sugar. He never meets with an endocrinologist, and another thing, his dental care is HORRENDOUS!! (Im sure you all know what dental care does to diabetes) I asked him where his toothbrush was A WEEK AFTER LIVING WITH US and he told me "I dont have one." I ran to Giant Eagle and bought him one and MADE him use it. Its just a bad bad situation.

This individual owns his own home, but is living with you? Odd situation, isn't it ...

Bottom line ... this is an adult we're talking about. While your concern is commendable, you cannot force anyone to do anything they don't want to do. You can educate, but that's about it.

This will not be the last non-compliant patient you will encounter.

bigsyis · Jun 1, 2007

If he doesn't pay he'll be hearing from collection agencies soon. Health care in this country is not free, not even to people on aid programs. If he has no financial means I don't think he can file for bankruptcy.

In addition to what Tazzi said, if he is truly indigent, or low-income, then he likely would qualify for Medicaid.

PiPhi2004 · Jun 1, 2007

His home is located 3 hours away. We are both from a very rural area in West Virginia. His mother and brother are currently living in the house, and has to take summer classes to keep his scholarships to continue going to school. He cant do that from his owned home. I was also really confused why he didnt have medicaid, but thats just what he told me. I wish I didnt care so much about his noncompliance, but when its in my face everyday I feel I have to do as much as I can. I hope I can at least get him to do some things, and maybe it will stick once he leaves in the fall.

happybunny1970 · Jun 1, 2007

Gads, youth is wasted on the young. Until he starts feeling the repercussions for these bad decisions, he's not likely to change. And he may make it to his 30s before that happens. Without proper care, though, by that time it will be too late for him to do much about it.

If this guy has Type I Diabetes, has been diagnosed and prescribed insulin, then he has been taught about his disease and the repercussions of not taking care of it. He's got to have some money somewhere, because you have to actually GO TO THE DOCTOR to get a prescription for insulin. And then there's the cost of the insulin and needles themselves, even if he forgoes accuchecks, which seems nutty since then how do you know how much to dose?

This guy is either clinically depressed or simply has a deathwish. And if he's attending a University, they have counseling services available to students, likewise general healthcare at a very low (if any) cost. He needs help, he needs counseling. But until he's willing to make an effort, there's not much you can do. Maybe he enjoys watching you suffer by worrying about him.

My advice to you: Don't give him anything for free, he should be earning his keep around the house in some way or other. And DON'T get yourself worked up trying to put him on a straight and narrow path that he does not want to be on. That's codependency, and VERY unhealthy for you. You can help, sure, to some extent -- but you can't fix this guy.

Altra, BSN, RN · Jun 1, 2007

His home is located 3 hours away. We are both from a very rural area in West Virginia. His mother and brother are currently living in the house, and has to take summer classes to keep his scholarships to continue going to school. He cant do that from his owned home. I was also really confused why he didnt have medicaid, but thats just what he told me. I wish I didnt care so much about his noncompliance, but when its in my face everyday I feel I have to do as much as I can. I hope I can at least get him to do some things, and maybe it will stick once he leaves in the fall.

Scholarships & college educations don't mean much if you're dead ...

Crash course in priority setting:

Priority #1: food, clothing, shelter

Priority #2: medical treatment needed to manage life-threatening illness, including legal/administrative means to have it provided

Priority # somewhere way down the list after #2: college education

With home ownership & "income" in the form of scholarships, he will most likely not qualify for Medicaid. This individual needs to get his life priorities in order.

Couldn't agree more with the previous poster re: co-dependency & enabling.

BTW -- if this individual has been given permission to live in your home, does everyone in your home know the s/s of hyper- & hypoglycemia, and are they aware of what to do & when to call EMS? This is a coroner's case waiting to happen.

PiPhi2004 · Jun 1, 2007

You guys have brought up some great points. The only ones that live here besides him are my husband and I. My husband is never home when he is and I am not, but he knows enough to call an ambulance or me if something doesnt seem right. As for enabling, I really cant kick him out, even though we only have a 1 bedroom apartment (he sleeps on the couch) which is doing wonderful things for our marriage *very sarcastic* but thats another story. He doesnt pay for anything, but he does help me with some of the cleaning when I ask. He has a job at the library but doesnt really contribute in any way financially. I know I am enabling him but I dont know what to do about it. I never really thought of it like that but good point.

miss arron · Jun 1, 2007

i would think the university has student health insurance available, which could be paid for with scholarships and/or student loans and will typically cover any and all conditions - including pre-existing. most even have health care facilities on campus.