Published Aug 23, 2011
Mimi2RN, ASN, RN
1,142 Posts
Yesterday, I had an appointment scheduled with my PCP. There were several people in the waiting room, but it was quiet.
After a few minutes, a teenage girl, maybe 16 yrs old or so came out from the exam room area over to an older woman sitting across from me.
The conversation went something like this.
Teenage girl"I have to have an MRI".
Older woman, presumably mom" You are not going to have an MRI! Who's going to pay for it?"
Girl"I need to have an MRI for my headaches".
Mom "You can't have an MRI, you need to go back and tell them that".
At that point, mom repeated that she couldn't pay for an MRI, and sent the girl back to the exam room. The girl did not look happy, but went back. Mom got up and headed down the stairs, girl came back out and followed her mom out.
The problems with health care just don't go away.I can totally understand mom's dilemma. She cared enough to take the girl to the doctor, but had no money to pay for the care. God willing, this girl has no life threatening problem, but what can we do in cases like this? It's just sad.
nerdtonurse?, BSN, RN
1 Article; 2,043 Posts
What's bad is if she'd had an MRI and something was wrong, they probably couldn't have afforded to pay for surgery/chemo/treatment, either. I've had too many patients who came in with advanced untreated breast CA, colon CA, prostate CA where they knew something was badly, badly wrong, and couldn't afford to go to the doctor because they were working jobs with no insurance, yet made too much for medicaid. One lady said, "what should I have done? I could either pay my rent or buy medical insurance and live in a box under a bridge."
xtxrn, ASN, RN
4,267 Posts
As sad as it is, people don't get diagnostic tests until things are so far progressed that treatment is much more difficult, or won't help. With a minor, there is the option of social services- which is a really lousy way to go about things- but if it means getting the kid the help she needs, sometimes the lousy way is the only way. Hopefully, the PCP has connections with a hospital social worker (vs Dept of Childrens' Services)...and something can get worked out. I saw a documentary about one hospital who will not allow a needed test to be left undone- they just write it off. More places (at least the really big ones, like this place probably have some charity assistance- IF people meet the incredibly low requirements for income- they make enough to pay rent, but not get medical care, so they're not eligible (BTDT).
People don't want to owe money- and that fear is even worse now. If the mom (or grandma) was raised by a parent who went through the Great Depression, it can be even worse. I've seen old ladies count out 3 squares of toilet paper (when they needed a whole roll-:)).
It's sad.
tyvin, BSN, RN
1,620 Posts
That's why there's medicaid. Also Catholic Charities and the like, people can get the treament if they go after it.
But depending on income (from any source) you don't get any help until you reach a "spend down", which is essentially a monthly deductible. Mine was so high it didn't leave enough for all of my rent, let alone utilities, supplement insurance, med co-pays, etc. Medicaid does NOT just pick up the bill for people who are having hard times. You need to reach a certain percentage of the poverty level to qualify without the unreasonable spend down....it gets down to having to decide if you're going to live indoors, or get prescribed tests/treatment. :two cents:
With the states being so screwed up financially (and they've been notoriously horrible for a long time), their requirements are not reachable- so too poor to afford care, but too much to get help.... it's messed up ....
Charities also have strict financial requirements. There are a LOT of people who don't make enough to get the care they need, but too much to get help.....
Jolie, BSN
6,375 Posts
Shame on that mother for sending her teenage daughter back into the office to tell the practitioner that she would not have an MRI.
Perhaps if she'd had a private conversation with the physician, office manager or asked for a number to contact a local hospital social worker, something could have been accomplished other than embarrassment in the waiting room and a closed door to further care.
In my experience, private sources of funding can be found for most urgent situations.
Spidey's mom, ADN, BSN, RN
11,305 Posts
shame on that mother for sending her teenage daughter back into the office to tell the practitioner that she would not have an mri.perhaps if she'd had a private conversation with the physician, office manager or asked for a number to contact a local hospital social worker, something could have been accomplished other than embarrassment in the waiting room and a closed door to further care.in my experience, private sources of funding can be found for most urgent situations.
perhaps if she'd had a private conversation with the physician, office manager or asked for a number to contact a local hospital social worker, something could have been accomplished other than embarrassment in the waiting room and a closed door to further care.
in my experience, private sources of funding can be found for most urgent situations.
that is what stuck out for me and what i thought the thread was about "something wrong with this picture".
definitely "shame on her".
i'm an older mom so i'm just gonna assume mom here and not grandma but it doesn't matter - mom should have gone back and talked with the physician and/or office staff, been referred to a social worker, etc. i know this happens probably every day and they know now to deal with it. jolie's right about private sources too.
i hope that young lady gets some help.
(p.s. nice to see you mimi)
JustBeachyNurse, LPN
13,957 Posts
However states have "state children's insurance plans" Family Care in NJ. sChIP in some states. If the family is up to 200% of the FPL (not a long stretch in many areas, though the parent's aren't covered they are counted in the "family size") coverage for minor child is no premium limited copay, up to 400% FPL a small premium is required. Though gross income is used, deductions such as child care/after school care and the like reduce the income considered.
My area has one of the highest enrollments (lowest number of uninsured children) as the health department & social services did a mass awareness campaign at the hospitals, family practice, and pediatric offices.
Mom may have insurance where the office copay is affordable but diagnostic testing goes toward the deductible & coinsurance. Been there done that...outpatient tests could cost $500 or more out of pocket! Forget it if one of the professionals are on the "non-preferred" provider list (as many radiologists, ER docs, and pathologists are).
Katie5
1,459 Posts
Healthcare Bills are astronomical with insurance. Try having no insurance~ it is unreal. Which makes me very empathetic to everyone.
Shame on that mother for sending her teenage daughter back into the office to tell the practitioner that she would not have an MRI.Perhaps if she'd had a private conversation with the physician, office manager or asked for a number to contact a local hospital social worker, something could have been accomplished other than embarrassment in the waiting room and a closed door to further care.In my experience, private sources of funding can be found for most urgent situations.
You with your hasty judgement on the mother, shame on that post.
How can you sit on your computer and pronounce judgment on her? Did you not read where the mother said she could not pay for the MRI. How can you possibly tell, it was not shame or embarrassment or hurt that she could not pay the bill and so had her daughter go in let the doctor know that.
And if I said shame on the doctor who treated her and saw a need for the MRI but did not offer any other options, would that solve the problem? No it would not dear, because the teen would still not have the MRI.
So instead of pronouncing judgement on another, we should instead look to see how to make the system work- the healthcare system is skewed... very skewed.
True, the mother might have gone in, but we don't know why she didnt. Keep your judgmental opinions to yourself!
nohika
506 Posts
You with your hasty judgement on the mother, shame on that post.How can you sit on your computer and pronounce judgment on her? Did you not read where the mother said she could not pay for the MRI. How can you possibly tell, it was not shame or embarrassment or hurt that she could not pay the bill and so had her daughter go in let the doctor know that.And if I said shame on the doctor who treated her and saw a need for the MRI but did not offer any other options, would that solve the problem? No it would not dear, because the teen would still not have the MRI.So instead of pronouncing judgement on another, we should instead look to see how to make the system work- the healthcare system is skewed... very skewed.True, the mother might have gone in, but we don't know why she didnt. Keep your judgmental opinions to yourself!
Yes, because it's better to shame your daughter in public in front of everyone, right? I don't have kids, but my Mom would've taken me aside and talked to me about why I couldn't do whatever instead of talking about it in the middle of the waiting room where everyone and their relatives could hear. The girl is a minor - parent should've talked to the doctor, learned why they wanted the MRI, and figured out if it was emergent and if there was any way they could afford it.
Shame on the mother indeed. That poor girl. I doubt she'll ask for any tests in the future because of this incident.
IaCountryGirl
157 Posts
It's getting harder to get assistance for things because of the amount of people needing it right now- there's only so much money to go around. Not to mention medicaid goes by income so they may very well not qualify because the income guidelines are so tight with medicaid.
I have a friend who had to have an MRI several years ago d/t a tumor on her pit gland. She was being seen at the university for it. I don't remember the details now, but she hunted around and found an office that does MRI's for a fraction of the cost that the university charges. It was surprising that the cost can vary so much between facilities.