Monday, April 4, 2011

Navigating the World of the Uninsured: Questions and Answers

In so many ways, I feel like I am in the calm before that storm.  I've been to the emergency room, where I received good care and prescriptions (Prednisone, Flexeril, and Vicodin).  The medications certainly helped to mitigate my pain, though I spent essentially a week laying on my right side (it was not fun).  During that week, walking any real distance was a very painful chore, and I tried my best not to, unless it was absolutely necessary.  Sleeping was an altogether different hurdle.  Let's just say that I did not get very much sleep.

During that first week, I had a couple of things that I needed to do, based on the emergency room doctor's recommendation.  I scheduled an appointment with a neurosurgeon's office, as well as scheduled an appointment with a community health center.  Making the appointment with the neurosurgeon was fine; however, when the receptionist asked me for the name of my insurance, it felt strange and a little foreboding to hear myself say that I didn't have insurance.  And yes, there was a subtle change in tone on the other end of the phone; it wasn't a negative change, but a change nonetheless.  It was enough to prompt me to say that I would be paying for the visit myself, as though that restored some element of pride that I'd never realized I has within me over health insurance.  And I was mad with myself for saying it, just as I'd finished the statement. 

The only thing that worried me about the call to the community health center was that it took two attempts to get someone to answer the phone so that I could set up my appointment.  I was hoping it was not a precursor to my pending experience.  Once I had someone on the line, things went smoothly, though I was surprised by the actual date of my appointment; let's just say that I have another week and a half before I am seen (I don't ever recall waiting that long to be seen when I set an appointment with my past doctors).

In the midst of all of this activity, I have not seen my bill from the emergency room trip.  When I told the person (the one with that giant machine to take your insurance and contact information, though we know which one is really more important in that moment) who comes into the holding area before a doctor, but after a nurse, sees you, that I didn't have insurance, she gave me a pamphlet and an application for charity assistance.  I was actually surprised that the hospital offered anything of the kind, but I will not be able to apply until after I receive the bill.

It was last Monday that I had my appointment with the neurosurgeon's office.  There was lots of paperwork to be filled out, which I certainly expected.  Sitting was still a bit of an issue, and standing was not the remedy, so I suffered a bit (and prayed that the additional dose of medication that I took, which was allowed, would kick in quickly).  I did find out that patients who were paying for their visit were given two payment options.  If you have a financial hardship, and want to pay for the visit in full, then the amount is cut in half.  If you have a financial hardship, and want to pay for the visit in installments, then the full amount is charged.  Actually, I found that to be fair, though I had no real idea of what I would be doing once I went through that door. 

I did not actually see the neurosurgeon.  However, I did work with his nurse practitioner.  Of course the world now knows that I am dealing with the symptom of sciatica.  The question of what is causing the sciatica remained the mystery.  Unfortunately, the way to resolve this mystery is through an MRI (even though I wanted to try the X-Ray, because it would have been $60, as opposed to the $2-$3,000 MRI).  The MRI was recommended, because it was determined that I have an unexplained weakness in my left leg, as well as a mysterious spasm in my left foot.  What wasn't a mystery to the nurse practitioner was the likelihood of me having to have surgery for my back.  With the exception of the weakness and the spasm, my symptoms led her to believe that I may have a herniated disc.

Since that visit, I've been trying to figure out paying for this MRI; I can't wrap my mind around the idea of paying for surgery, yet.  I've also begun researching Medicaid to see if it is actually an option for me here in Virginia.  I know that states have varying requirements when it comes to Medicaid, and there is a possibility that I may not qualify here in Virginia (actually, that wouldn't surprise me somehow).  Regardless, I have been sufficiently spooked about being my own boss in the midst of a painful recession.  I am still seeking consulting clients, and trying to cultivate (through selective volunteering) more solid client leads.  But, for the autonomy and freedom that come with going it all alone, it's a bitch when an emergency comes along, and one isn't fully prepared financially.  It's a lesson I know many self-employed people go through, with varying degrees of success. 

So, the adventure continues.

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