Random question about medical bills

classicdame, MSN, EdD · Jun 1, 2007

Besides the moral issue of not paying your way I wonder that in the future he might have trouble finding healthcare providers. He might have to wait till he is seriously ill before getting emergency care and then it would be like patchwork, not real continuity of care. Some people are just in denial about chronic illnesses. Once he loses something (leg, eye, heart or kidney function) he will get serious about it. May be too late by then of course to reverse anything.

TheCommuter, BSN, RN · Jun 2, 2007

Most type I diabetics are unable to obtain private health insurance because they are too expensive. Private medical insurance companies prefer to insure reasonably healthy patients, and diabetics are the least profitable patients in existence for an insurance company.

Your friend's only hopes of obtaining health insurance include Medicaid, or employer-sponsored health coverage. To obtain employer-sponsored health coverage, he would need to find a job that offered health insurance. But, I'll repeat that no private health insurer would cover your friend because he is no longer 'economically viable' due to his diagnosis of type I diabetes.

Jolie, BSN · Jun 2, 2007

Wow! What a twisted situation that really has very little to do with medical bills, and everything to do with personal integrity!

Most universities offer reasonably priced health insurance coverage for students that works much like group insurance sponsored by employers. Usually, everyone is eligible at the same price, with the healthy students balancing out the costs for those with acute or chronic conditions like diabetes. If this young man's university offers such a plan and he has declined to take advantage of it, then shame on him! In this case, it would be well worth his while and the responsible thing to do to get a job for the purpose of purchasing insurance. Having insurance coverage now would also prevent future insurance plans from excluding his diabetes as a pre-existing condition.

Even if insurance is unavailable and/or prohibitively expensive, he can and should utilize the low-cost services at the university health center for his on-going care. While that would not negate his $40K hospital bill, it would help him to avoid huge expenses in the future by keeping his disease under control, something I suspect he has NO interest in doing.

Anyone who lacks the initiative and self-respect to purchase (and use) a toothbrush is not likely to be interested in such abstract concepts as future devastating medical complications of an untreated disease. And why would he bother to do anything for himself when he has a substitute mother (the OP) who takes him in, buys his personal care items, and allows him to sponge room and board for nothing more than a few menial chores, all the while he owns a home that he could be using to garner some income by renting out rooms.

Not to mention that the OP is a married woman sharing a 1-bedroom apartment with her husband AND this ne'er-do-well con artist.

Puhleese! It is beyond my comprehension why the husband would put up with this arrangement for a minute, and even further beyond my comprehension why any self-respecting young woman would ask her husband to do so. Can anyone imagine a young bride allowing her husband to bring home a female classmate to bunk for the summer?

The young man with diabetes is not the only person in this scenario who is behaving irresponsibly.

Myxel67 · Jun 2, 2007

Wow!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.

Are the large medical bills related to recurring bouts of DKA because he doesn't use his insulin daily? Remind him that going just a a few days without insulin can kill him. Also, if he continues to neglect his health, he will qualify for Medicaid when he goes on dialysis.

He needs a job with group insurance (can't exclude preexisting conditions).

It might be impossible to get individual health insurance.

Often hospitals write off unpaid bills. He can also apply for charity care on future admissions. For example, my hospital will provide charity care if person earn less than 3 x poverty level. He can get insulin from patient assistace program with NovoNordisk or Lilly. Usually must earn less than 2 x poverty level to qualify for drug company pt assistance programs. I've never seen any mention of assets preventing qualification. He will need a tax return though.

Myxel67 · Jun 2, 2007

G
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?
You wouldn't believe the number of people (BOTH type 1 and type 2 DM) I see in my work who give insulin without ever checking BG. "I just eyeball it" or "I just go by how I feel" or "I can always tell what my bloodsugar is."
I don't know what kind of insulin this guy uses, but you can still get NPH and Regular insulin without a Rx. Insulin syringes are another matter though.
Remind him also that before the kidneys go, theres sexual impotence & blindness.

caliotter3 · Jun 2, 2007

When I was jobless, homeless, with no money, and in need of medical care, I went to the billing dept. of the county hospital and asked questions. I was told that I could apply to their "Ability to Pay Program". Fill out paperwork, and go on sliding scale billing. What surprised me was how nice the lady was and her telling me that a lot more people go on these programs than the general public would think. It is not just medicaid eligibility or nothing. Other options are available. From your post, I can tell you have your hands full with your friend. Good luck in helping him to help himself with his health.

celery · Jun 2, 2007

What is the relationship between diabetes and dental care? I am curious...I've not heard before.

Thanks!! Celery

purple1953reading · Jun 4, 2007

Owning a home does not negate his eligibility for Medicaid. As he does not live in his home,but owns it, the ones lving there should be paying rent. That could be a source of income. Medicaid usually lets them own a house, and car, but has a set limit for cash assets, like 1200-2000. BUT if he has enough money to not qualify, he had enough to make payments on his medical bills. Before nursing I was credit manager for our clinic. There are programs like Hill BUrton where they can qualify, where the state has provided the hosp funds for building or whatever, in return the hosp. gives free care to patients without ins. or money. BUT the hospital will send to credit and collection. They will investigate and see if he has the ability to pay, and take him to court, where he will have to sign repayment or be found guilty and forced to pay through court. IF he does not comply, the company can get the court to go after his assets, freeze all monies in accounts, etc. YOU cannot make him responsible, but the courts will eventually. Health ins. will probably be too expensive with preexisting conditions. IF his Diabetes is disabling, he might be able to qualify for disability, medicare, etc. Medicare supplements cannot have pre existing disqualifcations.

I believe there are state programs where he can qualify, with limited student ncome. BUT he needs to make payment arrangements. POINT out to him, that he does not pay you, but that you want him to make payments to hosp. You are in a hard situation. You don't want to kick him out, make things worse, but he needs to begin to accept responsibility for himself. IF he is in school,under the age of 23, could be coverd on Mothers or fathers health ins. through their work. Check it and see.

Daytonite, BSN, RN · Jun 5, 2007

medicaid has what is called "spindown" coverage. this is where a person doesn't qualify for medicaid, but has such skyhigh medical costs that it is overwhelming them. medicaid will determine how much a person must pay as a kind of copay and then medicaid pays the remainder of the medical costs. it depends as to whether or not your state provides this. the only way is for this person to go to social welfare people and present his situation. however, it doesn't sound like he's likely to even give a hoot.

if the various providers who he owes money to discover that he has real estate, they will sue him for what he owes and they will win. they will then go after his house for payment putting liens on it. he'll never be able to sell the property and make any money off it without satisfying the lien holders first. when these companies discover where he works they will garnish most of his paychecks to satisfy the court judgments they get against him. the new bankruptcy laws put people into payment plans to pay back their debts. it's very hard to get all one's debts discharged in a chapter 7 bankruptcy these days. so, if he doesn't address this issue of his medical bills, he's likely to have a lot of people on his tail trying to collect money from him. he'll never be able to get any kind of credit. he will probably die penniless from all the complications he's going to get from the diabetes. how does he pay for his insulin? how does he pay the doctor to get in to even get a prescription for insulin and needles? my cat needs insulin and with the needles, needles disposal, insulin, vet checks and lab work every couple of months it ain't cheap. the vet equivalent of the hb1ac blood test runs over $100.

please tell me he's not a nursing student.

Jo Dirt · Jun 5, 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.

If he is racking up more and more medical bills they will eventually sue him and freeze his assets, then when they take everything he has he will qualify for Medicaid.

As someone who has no health insurance myself, I have to say not everyone can just go get health insurance. Most of the places I have worked out of school either did not offer health insurance, the cost was prohibitive or the Insurance only covered major hospitalizations. My last insurance plan was so crummy it would only pay a very small percentage of anything, and as a result I have several thousand dollars owed in spite of paying the same for the privledge of having this so-called insurance.

He can go get dental insurance pretty cheap but for the first two years they will only cover preventative care, you can't just go sign up with a mouthful of rotten teeth and start getting root canals. He might be better of with dentures, especially since it doesn't look like oral hygiene is much of a concern to him.

Also, with his pre-existing condition I'd bet most insurance companies would not touch him, and with that being the case, he should qualify for Medicaid, and Medicaid will allow a recipient to own one piece of property plus a vehicle.

Ultimately, he will be the one who decides how important his health is.