More Options for People Who Can?t Afford Health Insurance

A while back Out of Your Rut had a blog post titled What to do if you absolutely can?t afford health insurance. There were some great suggestions in that post, including buying an accident insurance policy from someone like AFLAC, using convenient care clinics, and getting a part-time job that offers health insurance.

But it turns out that those suggestions are just scratching the surface of all the options for health care for people who can?t afford to purchase health insurance. There are a lot of other ways to get affordable health care without health insurance, and also a few more ways to get alternative types of coverage that aren?t technically health insurance but that can work just as well in many cases.

Here?s a brief description of a few of these options.

Cash-only doctors

Many doctors (although still a minority) do not participate in any insurance programs, instead they ask to be paid at the time they provide their services, just like nearly every other profession. Because they don?t have to pay to have administrative staff to deal with insurance bureaucrats, they usually charge less than what many insured people wind up paying as a co-pay!

Medical tourism

If you need surgical or hospital care, consider traveling out of your area to get it. There is a thriving medical tourism industry, with patients flying around the world to receive quality care at prices that are much lower than what would be charged by a U.S. hospital. In addition there are domestic medical tourism options, they can sometimes be more than foreign options but still much less than other U.S. hospitals.

Use a medical bill negotiator

If you must get care at a U.S. hospital (let?s face it, some conditions just don?t lend themselves to flying around to world to get care for), it?s likely that a U.S. hospital will try to bill you what are called ?chargemaster? rates. These are rates that are wildly inflated, bearing little relationship to the cost of the treatment and usually three to five times the price an insurer would pay.

In order to avoid these inflated rates, consider using a medical bill negotiating service. They can typically work with the hospital billing department to get you rates that are closer to what insurers pay, often saving thousands or even tens of thousands of dollars for self-pay patients who might otherwise think they have to pay the price on the bill.

Critical illness and fixed benefit policies

These are policies similar to the accident insurance discussed in the earlier post.
In the case of critical illness insurance, the insured receives a lump sum if they are diagnosed with any of the illnesses covered in the policy, typically including cancer, heart disease or a heart attack, and stroke. The amount paid depends on the benefit level selected, ranging from $5,000 all the way up to $1 million, similar to life insurance. The funds are paid directly to you, not the hospital or other provider.

Fixed-benefit policies resemble the old indemnity insurance policies, where the insurer pays the insured directly an amount based on the injury or illness treated. The basis for payment varies, Assurant Health (they really do have the most user-friendly web site for finding this sort of information) pays a percentage of what Medicare would pay. If the bill is less than the amount paid, the insured keeps the difference. If the bill is more, the insured has to come up with the difference.

One of the biggest advantages of these types of policies is that they are much less than health insurance, and provide benefits that can be as good or better for many people. On the minus side, they don?t qualify as health insurance under the Patient Protection and Affordable Care Act (aka ?Obamacare?) so you may have to pay the tax for being uninsured.

Health Sharing Organizations

These unique groups are voluntary organizations, originally founded as Christian ministries, whose members agree to share one another?s medical bills according to Biblical principles. In some ways they function similar to health insurance, in that they provide funding for large medical expenses that would otherwise be beyond the ability of most folks to pay. But they don?t cover all the same things as health insurance (for example, treatment for substance abuse isn?t part of the package, nor is abortion), and because they are entirely voluntary there?s no contractual obligation involved (though it seems to have worked fairly well for the 30+ years they?ve been around).

Three of the four organizations retain their Christian nature, and are only open to members who are practicing Christians. The fourth has recently changed its membership requirements to permit non-Christians to join. Two of the major benefits to joining a sharing organization are that they typically cost about half what conventional health insurance does, and members are exempt from having to pay Obamacare?s tax for being uninsured (because the organizations aren?t insurance, members are technically uninsured).

Final thoughts for people who can’t afford health insurance

There?s a myth that you can?t get affordable healthcare if you don?t have health insurance. While it?s true that health insurance can be beneficial, it?s flat-out wrong to say there aren?t affordable alternatives. In my view, it?s not only wrong, it?s dangerous, because it causes people to delay seeking care that they could easily afford if only they knew there were low-cost, high-quality options available to them.

What I?ve described here are just a few of the many options available to people who can?t afford health insurance, or who can but would prefer not to be part of the third-party payment system that dominates health care today, what I call ?bureaucratic medicine.? Hopefully, some of these or the other options that I write about regularly at my own blog, The Self-Pay Patient, can provide you with the information you need to get affordable healthcare even if you have no insurance or have a high-deductible plan!

Sean Parnell runs the blog The Self-Pay Patient, a web site that provides news, commentary, and information for people who directly pay some or all of their health care costs. He is also the author of an upcoming book on the same subject, The Self-Pay Patient.

(Also, please see the updated 20 Part-time Jobs With Health Insurance post for the most current list of employers who offer health coverage for their part-time staff.)

( Photo by sancho_panza )