Please think hard about it before you get an HSA compatible health-insurance plan - Mothering Forums
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#1 of 36 Old 01-31-2010, 01:32 AM - Thread Starter
 
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I decided to enroll our family in a high deductible HSA compatible insurance plan because we never go to the doctor and do all alternative medicine and the price for a PPO was sky high. Well here we are going onto day 6 of a hospital stay in the burn unit because my 18mo son has 3rd degree burns on his chest and shoulder.

Our out of pocket costs for this visit are going to be $10,000, and we pay $500/month for insurance for a family of three.

We were under contract to buy our first house and have to back out now. We don't even have enough to pay the out-of-pocket and will have to but several thousand on a credit card.

So to compound the stress of having an injured son, we also have to figure out how we're going to get through this financially.

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#2 of 36 Old 01-31-2010, 01:35 AM
 
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Don't put it on a cc.

Talk to the hospital, they might have a charity program or a payment plan to help out. Also, negotiate the cost down. Insurance wouldn't pay that much, so why should you, kwim?

and . It must be so terrifying to go through that. I hope your little one gets better really, really fast--miraculously fast or as close to it as possible.

Ami

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#3 of 36 Old 01-31-2010, 03:20 AM
 
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Apply for Medicaid.

The income limits for young babies are pretty high and they have progrmas for people that are over the limit too.
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#4 of 36 Old 01-31-2010, 10:05 AM
 
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Talk to the hospital about a payment plan and financial assistance. Also, wait for the bills to be processed by insurance. You probably won't pay the "cash" price, but you will probably pay the rate insurance would have paid (at least that's how DH's plan works). Even still, it will be a lot of money - probably up to the amount of your deductible.

Our insurance stinks as well. DH's plan has a $10,000 deductible and we would pay $1200 a month for family coverage. Sure, it has an HSA, but what good does that do with such a high deductible? For us, not much but I suppose it's better than nothing. The kids and I are on Medicaid right now, but I'll probably have to go on DH's plan at the end of June.

I hope your little guy is doing better!

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#5 of 36 Old 01-31-2010, 10:26 AM
 
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It's all out of whack. I am not pleased with the health care reform bill, but if it's not past, we have all lost and Big Pharm and the Insurance Industry has won. We are all screwed.

I am sorry your child is in the burn unit.

Anne, Mama to Conner 2/27/04 blahblah.gif  Gabrielle 2/6/06 W/LMC-TCS, Neurogenic Bladder, AFO & KAFO wearer, Neurogenic Bowel energy.gif & Delaney 5/12/08 mischievous.gif &  Beethoven cat.gif& Gizmo cat.gif

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#6 of 36 Old 01-31-2010, 01:20 PM
 
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I'm so sorry your little one is hurt. I agree with pp - do not put this on a credit card no matter the pressure from the hospital. They should have someone who can walk you through all of your payment options.

If you don't qualify for any programs or state help talk to local charities. If you can't find any help then wait until you can get a final itemized bill. Go over it with a fine toothed comb first and make sure there are no errors. Then negotiate with the hospital and pay what you can afford monthly.

Also, ask your doctors for suggestions - they might know of programs that could help.

I'm so surprised by the pressure hospitals put on families to provide payment before you even check out of the hospital. Do not cave in and just tell them because you will have to pay to meet your deductible you won't be able to make any decisions until you know what the final bill will be.

When I gave birth to my daughter the billing office called our room and talked to DH. The woman told him what the bill was and what our co-payment would be. She insisted he provide payment and being exhausted he gave her our debit card info thinking from what she told him it would be around $300. Well, when it showed up on our account they charged over $1,000. I called to tell them they'd made a mistake and was told it was no mistake. So, I had to transfer money around to help with cash flow and now, over six months later, they are posting refunds to our bank account. Never again - I'll ask to be billed for it. It's not like they can kick you out for non-payment.

Best wishes.
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#7 of 36 Old 01-31-2010, 01:23 PM
 
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I'm really sorry. The state of debate on health insurance issues in this country is most discouraging and disheartening. I'm with you on HSAs. They are good for those with tons of money or those who never need medical care, but are a pit for everyone else.

Agree that you should NOT be pressured into charging it. Try and bargain them down. If they think you aren't going to wind up paying anything if they don't, they really don't have a choice. It's not YOUR fault that our country's health care system is a joke and don't for a minute let anyone make you think it is.

Best wishes.
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#8 of 36 Old 01-31-2010, 01:31 PM
 
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Our out of pocket for our insurance is $10,500 as well. We have $4500 set back, but we are short the $6000 (I'm having a baby this summer).

We plan on making payments to the hospital. In the past 2 years, I've had 2 other hospitalizations (with different insurance, so lower OOP, though). We've just made payments both times. THe hospital works with us.

Our state has some of the lower limits for Medicaid (200% of poverty level for pregnant women and children under 5; 100% of poverty level for children under 18 and disabled adults; little coverage for others), so that's not a help.

But, the hospital is easy to work with on payments (interest free), we've found. Don't put it on a credit card!!
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#9 of 36 Old 01-31-2010, 03:48 PM
 
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I hope your little one recovers completely. Many hugs!!!

On the topic of HSA-compatible health insurance, I think it depends on the policy and the insured people/family. Last year, DH's company went with an HSA-compatible plan that was very good for us. The family deductible was $5K and the policy covered preventive care appointments 100% before deductible. That was doable and the cost for me was reasonable. DH's employer pays his 100% and pays 0% of mine, but I can only get group insurance and am, therefore, at their mercy. It is a TINY firm and only 3 employees are on the group plan plus 1-2 spouses.

This year, that plan went up more than 30% and his firm changed to a new plan. The new plan sucks for us. The family deductible is $10K! The new plan is not HSA-compatible, either. The co-pays are only $15, which is great if you go to the doctor often. We don't. The only good thing is the premium for me went down.

Our DD has an individual policy that is far less than what the group plan could offer. It wasn't a very good policy, though. (She rarely needs healthcare, so it was serviceable.) I had planned to get her on the above plan when open enrollment came up, but they switched the plan and her premium would be triple her current premium and the plan isn't any better for her. I went to ehealthinsurance.com and found her a better plan and the premium is a few dollars less per month than her current plan.

We had planned to increase our contribution to the HSA this year. Instead, we are taking all of the HSA contribution and the premium differences and putting them into an ING Direct savings account just for peace of mind. We can still withdraw from the HSA for qualified expenses, but we can no longer add to it.

Personally, I would rather have the HSA-compatible plan we had last year even at the 30% higher premium for me than the plan we now have that is not HSA-compatible. It isn't so much a function of being HSA-compatible or not. It is how the plan works for your family. We now have a deductible that is twice as high and no tax benefits whatsoever.

Our healthcare system in this country needs a major overhaul.

"Kind words can be short and easy to speak, but their echoes are truly endless." - Mother Teresa

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#10 of 36 Old 01-31-2010, 04:04 PM
 
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So I'm curious, do you think this was a good idea? We did a $2500 deductible plan that only covers emergencies.

Mama to expecting Babe 2
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#11 of 36 Old 01-31-2010, 06:38 PM
 
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Quote:
Originally Posted by goldingoddess View Post
I decided to enroll our family in a high deductible HSA compatible insurance plan because we never go to the doctor and do all alternative medicine and the price for a PPO was sky high. Well here we are going onto day 6 of a hospital stay in the burn unit because my 18mo son has 3rd degree burns on his chest and shoulder.

Our out of pocket costs for this visit are going to be $10,000, and we pay $500/month for insurance for a family of three.

We were under contract to buy our first house and have to back out now. We don't even have enough to pay the out-of-pocket and will have to but several thousand on a credit card.

So to compound the stress of having an injured son, we also have to figure out how we're going to get through this financially.
I am sorry to hear about your son and that the billing department of the hospital is being so jerky.

That being said if I could get my current plan for $500 month with no changes other than having my deductible go up my a factor of 30 I'd be all over it.

Last year my employer paid over $15,000 on premiums for my family so that we could have two well child visits, one adult physical, a trip to the allergist, and a mamogram (which a month later the recommendations changed and I probabily wouldn't have gotten). I would have gladly paid for all of those with a HSA with my own money if I could have gotten paid the difference between the premium with the HSA (especially if it was as low as yours) and the premium with my current plan. Some years your (and me too) going to met even high deductible.

Anyway I don't think HSA are bad. I think they might not be a good choice for people who neither have money for the deductible nor have employers that pay for all or part of the deductible.
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#12 of 36 Old 01-31-2010, 07:41 PM
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Sorry about your little one and hope he recovers soon!
It sounds like you just have a terrible plan. We switched to a HSA compatible plan this year and our premiums are only $100/month with a $6000family deductible. The company also puts $1000 in our HSA. Point is, they certainly are not all bad, sorry yours is!
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#13 of 36 Old 01-31-2010, 10:07 PM
 
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Sending more good thoughts your way for a complete recovery for your little boy.

I totally agree about the HSA/High-Deductible Health Plan (we have had one for three or four years.) They may be a nice way to put aside some extra savings if you're healthy & wealthy & childless. For the rest of us... no.

Here's a quote from John Goodman, president of the National Center for Policy Analysis and basically the 'father' of the HSA:

"If a mother wakes up in the middle of the night with a sick child, we want her to think about the cost of the emergency room visit."

What more does anyone need to know about whether or not these are designed to be a good option for families?

Decluttering SAHM of three. Going for 2011 items in 2011.
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#14 of 36 Old 01-31-2010, 11:19 PM
 
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hugs to you and sorry for your little guy,
i will repeat what others have said, dont pay the entire amount!
1. if you do decide to pay, most hospitals have a discount for paying your bills right away, our hospital can discount you up to 30% if you do that, but you have to ASK about it.
2. ask to talk to a financial counselor or patient advocate. they might be able to provide you info about different programs available to help with pay. examples of that include hospital fund or county indigent fund. they should be pretty helpful because the hospital would rather get paid from an alternative source than not get paid at all.
3. negotiate. best of all with the doctor, dont go to the billing with this, because the billing has no personal interest, and the doc does - they too want to get paid, even if its not 100%.
i work at a hospital and it is astounding how many people simply ignore their bills, they dont even want to go on a payment plan, they just hope it will disappear, or i dont know what. lots and lots of people abuse the system, too, so the hospital will be more than willing to cooperate since you are trying to have it paid in full
good luck and hope it works out
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#15 of 36 Old 02-01-2010, 12:56 AM
 
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I agree with what others are telling you.

Do apply for financial assistance through the hospital. We got assistance for Ds' NICU stay, we were surprised because we usually don't qualify for anything like that.

I would also not pay anything until it is resolved through insurance. I would definitely not put anything on a credit card.

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#16 of 36 Old 02-01-2010, 12:50 PM
 
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OP- I am sorry about your son. They will take payments. Offer like $250/mo or something.

I have found the HSA love though- Our PPO coverage was $950/mo with a $2500 deductable ($20 copays for the dr though). We switched to an HSA with a $3800 max for $550/mo. To make it work you must figure that you very well could pay your max though.

The other thing we do is have an AFLAC emergency policy- in the OP situation she would have a nice big check coming from AFLAC to the tune of thousands that would have helped her to pay her deductible. Our accident policy is $60/mo for our family.

I do make health care decisions based on money now though. I am not saying I won't take my kids to the doctor or er if need be- but I don't race them to the dr for just anything now though. Writing out a $150 check makes me think about it a little more. I don't see how this is wrong- someone has to pay for that visit or the er- and that someone is ultimately me- either through writing the check, paying the insurance or as a taxpayer. It isn't like uncle sam doesn't get reimbursed through taxes.

Iowaorganic- mama to DD (1/5/06), DS1 (4/9/07), DS2 (1/22/09), DS3 (12/10/10), DD2 (7/6/12) and a new kid due in early 2014

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#17 of 36 Old 02-01-2010, 01:02 PM
 
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Don't put it on a credit card! They have zero obligation to work with you if you charge it, and you can be sure the credit card company won't be understanding, either.

Talk to the financial office about payment plans, etc., and they will often reduce your amount/work out extended-time payments, or even write your remaining debt off after a period of time ..... but if you put it on a credit card, it's not their problem anymore.



for you and your son - I hope for good healing!!

Mama to A 8/05 and S 11/06
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#18 of 36 Old 02-01-2010, 01:12 PM
 
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I'm so sorry It sounds awful, poor baby.

Make sure you apply for financial assistance from the hospital. I wasted thousands at Childrens before one customer service guy asked me more detailed questions and I found out that the cutoff is 118000per year. So, I've been pretty much throwing money at them and racking up debt etc. when I qualified for financial aid.

You can pay hospitals for a looong time. Don't feel that you have to do this all at once. You may still be good to get your house. Do your taxes with mortgage interest and without and see what that gets you. Ours saves us 20,000 a year in taxes. Don't make any quick decisions.

We have an HSA compatible plan too, but it's just what's offered through work. It did end up saving money for us...about 400 last year, but only because we neglected to put money in it to pay for most of our med. bills.

1. apply for financial aid...pay slowly, put nothing on credit cards..NOTHING
2. Rethink not buying the house. It could be a good tax shelter.
3. 10,000 will NOT break you.


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#19 of 36 Old 02-01-2010, 01:56 PM
 
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Do your taxes with mortgage interest and without and see what that gets you. Ours saves us 20,000 a year in taxes. Don't make any quick decisions.
Very OT, but how??

We pay about $12,000 in mortgage interest a year, and it saves us about $1000 on taxes. No where near $20,000.

Do you have a really big mortgage?? A huge income?? How's this work??
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#20 of 36 Old 02-01-2010, 02:59 PM - Thread Starter
 
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OP here, I wanted to thank everyone for their responses. We're still here in the hospital, and they want to do skin graft surgery tomorrow which will keep us here for another week. As time has gone on it has become apparent that money does not matter just my babies health and well-being matter, the money is secondary.

I know the HSA is nice for people who have the money to pay the max out of pocket, which is different then the deductible, our deductible was $5800 which sounded like a manageable number, but the max out-of-pocket is $10,000 wich is very easy to meet with even a short hospitalization. When we got the HSA we thought it would be plenty easy to save enough over two years to have the max out-of-pocket in ou HSA, we are one year in, and in that year a lot happened, like moving cross-country, renting a new house in the 2nd most HCOL in the country (bay area)and having to buy a new car.

I know it works for some people and I'm not saying it is bad for everyone, but I'm just sharing our experience because we thought we would be able to put more in the HSA, but we have only put in ~1600 in the past year and now we are kinda screwed. We would have been so much better off doing a PPO or even a lower deductible HSA compatible insurance.

Thank you everyone for the support and advice. Because of this we will not be putting the debt on a CC and will instead try to do a payment plan with the hospital...if they let us.

Julia, mama to Bumpa 2008, and The Mole 2011

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#21 of 36 Old 02-01-2010, 03:19 PM
 
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Please talk to the hospital about programs for the under insured. Many hospitals, especially the nonprofits, have them. My sister had 75% of her deductible waved because she owed several thousands after emergency surgery. As a hospital employee, I donate money every month toward such a program.
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#22 of 36 Old 02-01-2010, 07:10 PM
 
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Oh my goodness. I am so sorry. My DD (21 months) had the same sort of thing last month. With our insurance we are OK but wow our max out of pocket is 3500 but the accident was 12/19 and she was d/c on 1/1. So all the recovery stuff/last day of hospital starts over on a new year so we'll be doing max out of pocket twice I think.

The agony of watching this all play out is soo hard. I haven't found anyone who has gone through this. If you would like to see how it has played out for us you can e-mail me and I'll send you the link to my blog. We're at 6 weeks post burn-5.5 since the skin grafts. We were back today for a check up and to get fitted for a compression shirt. Please hang in there. It was actually a week and a half we were there post grafts and then went home doing some simple dressing changes at home. Please let me know if I can help you at all. This is soooooooo hard. Please feel free to e-mail me about anything. I felt so alone and like I was the only one this had ever happened to. It just took a second....

again hugs
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#23 of 36 Old 02-01-2010, 10:27 PM
 
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Very OT, but how??

We pay about $12,000 in mortgage interest a year, and it saves us about $1000 on taxes. No where near $20,000.

Do you have a really big mortgage?? A huge income?? How's this work??
We live in a very expensive area, so that's part of it. I did my estimated taxes with our standard deduction and taxes, then compared it with the itemized deductions of mortgage interest and property taxes. The mortgage knocked us down to a lower tax bracket and so we pay a smaller percent. If you're in the lowest bracket and living in a low cost of living area, then it may not be that much of a help. But do those taxes both ways and see.

You had me curious, so I went back and rechecked (it's been a few years and we have another child). With more kids and a 401k contribution, we save less on the mortgage deduction , but it's still pretty substantial, the standard tax of 9362 + 25% of all over 68000. That vs. straight 15% makes a big difference. I think it depends on how many kids you have and how close to the line you are, what other deductions you have, etc.

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#24 of 36 Old 02-01-2010, 10:32 PM
 
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OP here, I wanted to thank everyone for their responses. We're still here in the hospital, and they want to do skin graft surgery tomorrow which will keep us here for another week. As time has gone on it has become apparent that money does not matter just my babies health and well-being matter, the money is secondary.

I know the HSA is nice for people who have the money to pay the max out of pocket, which is different then the deductible, our deductible was $5800 which sounded like a manageable number, but the max out-of-pocket is $10,000 wich is very easy to meet with even a short hospitalization. When we got the HSA we thought it would be plenty easy to save enough over two years to have the max out-of-pocket in ou HSA, we are one year in, and in that year a lot happened, like moving cross-country, renting a new house in the 2nd most HCOL in the country (bay area)and having to buy a new car.

I know it works for some people and I'm not saying it is bad for everyone, but I'm just sharing our experience because we thought we would be able to put more in the HSA, but we have only put in ~1600 in the past year and now we are kinda screwed. We would have been so much better off doing a PPO or even a lower deductible HSA compatible insurance.

Thank you everyone for the support and advice. Because of this we will not be putting the debt on a CC and will instead try to do a payment plan with the hospital...if they let us.
If they let you? They have no choice. They don't have to know that you have open credit to pay this. If you send them any money every 30 days, then they can't refer you to collections. If they cash the check anyway. I've heard of people sending 25$ every 30 days and since the check gets cashed, it doesn't go to collections. Most people don't have 10,000 in their pockets. They dont' have a choice except to work with you. Nobody can force you to put something on credit.

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#25 of 36 Old 02-02-2010, 10:56 AM
 
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I've already responded on this thread, but we got to experience this last night. DH was coughing up blood so he went to the ER. They did some chest x-rays, CAT scan, EKG, etc and wanted to admit him, but he refused (not sure why). He just got qualified last week for the state medicaid plan due to our income being so low so at least we have that as secondary insurance and I know it's effective from the date of application but I don't know how it will all work.

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#26 of 36 Old 02-02-2010, 01:29 PM
 
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If they let you? They have no choice. They don't have to know that you have open credit to pay this. If you send them any money every 30 days, then they can't refer you to collections. If they cash the check anyway. I've heard of people sending 25$ every 30 days and since the check gets cashed, it doesn't go to collections. Most people don't have 10,000 in their pockets. They dont' have a choice except to work with you. Nobody can force you to put something on credit.
I did want to say some creditors (hospital/medical) will still send you to collections even if you are paying something if its less that they tell you they will accept. I know because this happened to me on a bill that was less than $500. I paid off $200 over a year and they said that was too little and sent me to collections.

That said, I have had hospitals work with me. When my dd was born 4.5 years ago I had to transfer to the hospital and was nervous because we had a high deductible policy (15K) and knew I did not have the money to pay my portion. Well they have worked with us taking $5 a month since she was born and haven't sent us to collections.

I would not put this on a credit card unless I had the means to pay that card off ASAP. What happens if you lose your income. No, they may play tough especially when so many are underinsured or not insured at all but the bottom line is you cannot get blood from a turnip.

Mothering since 1992...its one of the many hats I wear.
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#27 of 36 Old 02-02-2010, 04:10 PM
 
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Julia, you need to talk to the hospital's financial specialist. If they don't have one, tell them you want to talk to one from an affiliated hospital.

A close friend of mine was a hospital financial specialist for years (she's now a SAHM). If you want, pm me your email, and I'll email her. She is an awesome friend, very smart, and I'm sure would be a great resource.

Your child will qualify for a Medicaid spend down account, because children do. In the event that some crazy set of circumstances prohibits your child from getting a Medicaid spend down account, hospitals have been known to waive the entire bill. My friend did this more than once, including a bill for my cousin.

DON'T PUT ANYTHING ON A CREDIT CARD. DON'T TALK TO BILLING. You need a financial specialist, ignore everyone else.

So many hugs and good vibes to your little one.

Trying to turn hearts and minds toward universal healthcare, one post at a time.
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#28 of 36 Old 02-02-2010, 05:39 PM
 
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No financial advice, especially as I'm in Canada. FWIW, I will say my very low-income parents never saw a bill. Yes, we pay for health care by our taxes, but for our family we were very glad for our health care system and still are.

I just wanted to respond as an adult burn survivor. I had 60% of my lower body 3rd degree thermal burns, plus 3rd and 2nd degree on my chest and left hand. I'm 42 years old now and though there were many grafts, compression stockings, etc. growing up, I'm completely fine (though scarred physically) now. I actually could have had more cosmetic/reconstructive surgery done, but I feel completely comfortable in my skin! I wear my burn scars proudly. It was WAY harder on my mom and her fear after the accident was much harder for me in every way than the actual accident and surgeries.

FWIW, I hear you say you do natural therapies. Now is the time for that! I had to see a burn specialist when I became pregnant with dd, because there was concern my skin wouldn't stretch across the tight band of scarring on my belly. Well, it did. The doctor said I'd probably have lots more stretch marks than average. Well, guess what? I didn't have a single one!! I credit my sister, who was a naturopath, with literally saving my skin. I am badly scarred, but my skin is supple and, I think, beautiful! Oh, and I don't blame anyone for the accident, though my mom blames herself. I made it just fine and so will your son. Much love to you.
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#29 of 36 Old 02-02-2010, 06:17 PM
 
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I just thought of something. Do the Shriners work in the US? I thought they might be international. I know in my situation, even though hospital/medical bills were covered through the health care system, things like compression stockings weren't. Shriners covered that, plus out-of-town expenses for my mother to accompany me to hospital; which I often had to go to in a different city. They specialize in providing care for burn survivors. I know they run hospitals, but they just wrote cheques to my parents to cover costs.
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#30 of 36 Old 02-03-2010, 10:32 AM
 
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yes the shriners do work in the US. One called me after we were home with DD. I thought about mentioning it earlier but with the surgery scheduled I wasn't sure there was any point. You do have to have a referal by a shriner though.
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