Options for the Uninsured

Needing medical attention can be stressful enough without adding the uncertainty and confusion of not having health insurance to help pay for needed services. Patients who face large bills sometimes go without treatment just to avoid the costs. However, uninsured patients retain several realistic options to help them get the care they need at a price they can afford.

Private Pay

• Almost every physician practice or hospital will accept a private-pay patient. Private-pay patients, because they lack health insurance, sometimes qualify for a cash discount. Although doctors' offices and urgent-care centers typically require cash up-front, hospitals will usually permit emergency admissions with no down payment. The hospital will send a financial counselor to work out payment terms. Because of federal regulations, emergency rooms are forbidden from asking any questions about a patient's ability to pay for services until a physician has evaluated the patient's medical condition.

Loans

• Some hospitals work with patients to secure low-interest loans to cover the cost of medical conditions. Although terms and conditions vary, the credit criteria are generally less strict than most other forms of personal credit. These loans may also be used to help pay for treatments--like plastic surgery--that an insured patient's insurance company refuses to cover. For example, Spectrum Health, a Michigan-based health system, offers interest-free, 25-month revolving lines of credit through a third-party finance company for patients who cannot meet their liability out-of-pocket.

Charity Care

• Some hospitals may be willing to forgive some or all of a patient's bill. Hospitals--especially not-for-profit institutions--have an incentive, both under the tax code and in terms of public relations, to maximize their "community benefit." This means that some patients, usually those who suffer emergency hospitalization, may receive significant discounts if they provide documentation demonstrating their assets and lack of means to pay their medical bill. Some physician practices also offer free clinics, although these are rarely advertised. Call your local county medical society for information about free clinics in your area.

Clinics

• Look for health clinics in the area. Many public health departments sponsor free or low-cost clinics that offer screenings and basic medical care. Some chain stores like Wal-Mart host on-site doctors and nurse practitioners who will provide basic diagnostic care to patients for a low up-front fee. Also, some churches sponsor basic-care clinics--especially congregations that have medical professionals in their midst.