A friend of many of my friends was beaten up and hospitalized.

[xiphias]

There's more information here.

He was beaten up for wearing a skirt, and has very little money, no insurance, and now hospital bills.

People are putting together paypal donations for him, but what I'd like to know, more than that, is what other recourse he's got.

I know I've got people on my friends list who know quite a bit about how hospitals are and are not able to help out the indigent. Anyone know anything about hospitals in Maryland?

Comments

[pocketnaomi.livejournal.com]

They have to stabilize you such that your condition is not immediately life-threatening. They don't have to do a damn thing else for free. As I understand it, he walked in with his injuried non-life-threatening, though I'm not sure he was positive of that before they looked him over -- anything he permitted them to do after ascertaining that he wasn't immediately about to haemorrhage to death or somesuch, he has to pay for.

[tikva.livejournal.com]

1. I don't know if MD has a free care pool, but I bet the DPH would.


2. He's in MD?!? Anywhere near me? Can I bring him something? Does he need therapeutic puppy kisses? Ack!

[juliansinger.livejournal.com]

Baltimore.

Dunno where you are, though, so that might not help.

[gingicat]

He's in Baltimore, so that would be an Amtrak (IIRC) ride for you.

for starters

[burgundy.livejournal.com]

First thing he should do is ask to speak to a hospital social worker. I guarantee they've dealt with things like this before. If anyone should have advice, it's them.

Second is to see if there's any kind of compensation fund for crime victims. Some areas have them; he may be able to get some money, and every little bit will help.

Third is find out if his hospital is Hill-Burton obligated. Under the Hill-Burton program, any hospital or health care facility that receives government funds (including for things like construction) is required to provide a certain amount of services for free to people unable to pay. Even if his hospital participates, there's no guarantee that his procedures will be covered, but it's something to ask about.

He can also call the area United Way. They should have an information and referral service, or at the very least a directory of United Way agencies there. They may be able to point him towards local places that help with medical bills. If that's not enough, there are almost always agencies in major metropolitan areas that will help with things like rent and utilities for people in crisis, and any money he's able to get for other things will help offset the medical costs. Also, some places provide free financial counseling; he may be able to get more advice there.

addendum

[burgundy.livejournal.com]

Some localities have specific medical discount plans for the uninsured. In Harris County, for example (where Houston is), there's the Gold Card. If you get a Gold Card, you can get care at public hospitals for I think a slidiing scale (it's been a while since I was in Harris County, I'm fuzzy on the details). The best part was that, if you were hospitalized, you had 30 days to apply for a Gold Card to have it be retroactive. I have no idea what the Baltimore equivalent might be, but it can't hurt to find out.

[jehanna.livejournal.com]

Posted to my own journal. I think people on my friends list have matching clues.

Sometimes my Ari talks about getting a concealed-carry permit (she already knows how to shoot and it's pretty easy to get such a thing in PA as compared to, say, MA). Hearing this story only makes me feel more certain that it's a good idea for her.

I don't think it's as much of a risk in the burbs where we often are, but we do go into Philly sometimes, and Philly has plenty of the same yuck factor as Baltimore and environs safety-wise.

I'm very much on the warpath over things like this lately. The frustration is growing, the solutions are not forthcoming.

[xiphias.livejournal.com]

I'm a big fan of people I like having access to weapons, personally.

[beardedone.livejournal.com]

Sorry, but I can't help you much there, as I only deal with the non-profits that are recognized as exempt under Section 501(c)(3) of the Internal Revenue Code. While those are required to provide care to indigent persons, I am not up on what the legal requirements are as to the number of persons served, the number of those who were not billed, and what those persons have to do to show their status as an indigent person.

For-profit hospitals are subject to less restrictions than the non-profits.

[mattblum.livejournal.com]

There are actually no for-profit hospitals in the entire state of Maryland, according to my research.

[mattblum.livejournal.com]

I think burgundy's ideas are very good ones. I think he should also apply, if he hasn't already, for Medicaid. He may not qualify, but he won't know until he tries, and it's not as though there's a penalty for applying and being rejected.

This policy paper (PDF) has a fairly good analysis of how health care for uninsured patients is managed in Maryland. It mentions that most hospitals have ways to set up reasonable payment plans. It also mentions that, due to the way Maryland has managed rate-setting for hospitals, hospitals are better than in many states about not pursuing people who genuinely can't pay their bills (as opposed to those who can, but don't).

Hope this helps.

[bouncingleaf.livejournal.com]

*wave* here via jehanna.

Uh, my hospital experience was that I had an ER admission to George Washington University Hospital in DC about 2 years ago, at a time when I had no job and no insurance.

I met with a financial person on the first full day I was there. She came to me, I hadn't asked. She told me essentially "your health comes first. focus on getting better now. we'll sort out the money stuff later. here's my card. don't even think about it again until you go home." I realize I was lucky to be greeted with this attitude.

When I did get out, there were three bills to deal with: the hospital itself, the physician's group, and the head surgeon. In that order, but the hospital bill being far more than the other two combined.

I applied for, and was granted, coverage via the hospital charity program. They paid the hospital bill. I have paid the physician and head surgeon bills out of pocket (well... not exactly, but that'll do).

I was told at some point that medical bills can't go on your credit report for privacy reasons. So I just simply didn't pay the physician group bill for 6-8 months or so until I had the money. I later got a copy of my credit report, and it appears that the rumor was mostly true, at least in my case. There was no mention of my medical debt, how much it was, how late I was, anything like that. What was on my report though was an inquiry into my credit from an agency that was pretty clearly a collections agency. Just an inquiry. Your Mileage May Vary, etc.

As the daughter of a hospital social worker, I second the suggestion of talking with a hospital social worker.

I'm afraid that my story isn't a whole lot of use, but there it is.

I'm sorry to hear of what happened, that really sucks. :( I hope your friend has a speedy recovery and a minimum of financial woes.

[mitchellf.livejournal.com]

I, personally, don't know that much about the hospitals here in the Baltimore area, but my sister-in-law does (after all she's worked in 3 of them, and her children were all born in a 4th).

Let me know what you would like me to ask her, and I can find out for you.

Also, I'm more than happy to help him out if I can, since I live here, in Baltimore, and now have a vehicle that I can drive around again (icky rental car, but it will do until I get my car back). So, even though I don't know him, if he needs transportation, or chicken soup, or just a visit from someone, please let me know.

--me

[estherchaya.livejournal.com]

Do you know what hospital he was at? My husband works at the University of Maryland Medical Center in Baltimore.

Most hospitals have programs for people that can't pay their hospital bills. Asking to speak with a hospital social worker is a good first step. Another thing to do is to contact the billing office after he gets his bill and ask what can be worked out. Some of the hospitals have a flat fee for people without insurance and will work out a plan (or write off) for any remaining balance.

Honestly at this point, he needs to wait for the bill to come through and see what it costs. I didn't go back and read the posts for details, so I don't know what tests and such they did (xrays? CT Scan?), and that can make a huge difference in the bill. Once he's gotten the bill, he should work out how much he CAN pay (if anything) and call the billing office to try to work something out. As I said, many hospitals have funds to just write off a certain amount for patients who can't pay.

Without more details, I'm not sure what else I can say other than I'm genuinely sorry that he's had to go through this.

[jehanna.livejournal.com]

Just on the off-chance they might know where to go in Baltimore since we're sort of nearby, your friend might want to contact The Mazzoni Center and ask them what helpful organizations are in hir vicinity. (Didn't read enough of hir LJ to know which pronoun to use.)

The center claims not to turn people away for inability to pay, too, so they're also a possible resource in and of themselves.

Medical care

[(Anonymous)]

Many good comments are above. The two most important steps are contacting a social worker and the billing office. I recommend that your friend contact the billing office immediately, rather than wait until the bill comes. If their procedures require that he wait, they'll let him know, but if not, then he can get the paperwork started now so he's farther along the process when the bill does come. Since he probably went to an Emergency Room, I can pretty much guarantee that the hospital bill will be hefty.

Depending on what he had done, he may receive separate bills from a surgeon, the E.R. doctor, a radiologist, a pathologist, or a cardiologist. Basically, any doctor who was involved with his care is likely to bill separately from the hospital. This is related to the way Medicare pays for services, so please don't blame the hospital for this. Contrary to what many people think, relatively few doctors actually are paid by the hospital in which they work.

When the bills from the doctors arrive, your friend should contact each physician's billing office, and try to arrange free care, a reduced fee, or a payment schedule that he can live with. If he's been approved for free care by the hospital, sometimes that will help persuade the physician. I don't recommend that he simply ignore the bills. There's no reason that an unpaid medical debt can't be put on his credit record. The fact that he failed to pay Dr. Smith doesn't reveal anything covered under HIPAA. Doctors and hospitals have every debt-collection recourse available to any creditor. In most cases they choose not to go so far as to ruin a person's credit rating or take hir home, but they could do it if they wished. Most facilities will refer accounts overdue beyond a certain point to a collection agency, and those agencies are much less willing to work with you.

Good luck to your friend. I hope he recovers quickly, both physically and emotionally. - Felis Sidus