No insurance, no clue what Doctor to see

[Acastus]

I will lecture you about the need for insurance after your are fixed. Try here, assuming your sig is accurate:

https://www.freeclinics.com/co/ks-shawnee

[mm1970]

(Her husband has insurance but for some reason he can't get family coverage - really?)

Her husband's employer may refuse to offer coverage to the SO if the SO has coverage available through their own job, no matter how crappy and/or insanely expensive that might be for the other spouse or the couple together.

My husband's old employer had a policy like that. It wasn't a problem for us at the time because I was not working, but I can see how it would easily be a major PITA for other couples caught in that.

Sometimes they don't offer family coverage, sometimes it's just really expensive (>$1000/month)

[RH]

Your body is telling you something is wrong with it. Don't ignore it. Your body is a smart little cookie.

[netskyblue]

(Her husband has insurance but for some reason he can't get family coverage - really?)

Her husband's employer may refuse to offer coverage to the SO if the SO has coverage available through their own job, no matter how crappy and/or insanely expensive that might be for the other spouse or the couple together.

My husband's old employer had a policy like that. It wasn't a problem for us at the time because I was not working, but I can see how it would easily be a major PITA for other couples caught in that.

Sometimes they don't offer family coverage, sometimes it's just really expensive (>$1000/month)

Yeah, my old employer, when I was making 30k/year, offered family coverage for over $700/mo.  That was the price of our RENT.  And no distinction between insuring one other person or eight other people (or more).

[CharChar]

I guess you didn't get the memo after all - you do not have the luxury of putting off seeing a doctor.
You are still trading your health for money. We get why you might choose to do so, at least some of us anyway. Regardless, you can no longer afford not to have medical insurance. 
Good Luck, providence has seen fit to give you a warning, heed it, before you run out of time and end up in serious trouble.

Maybe it would help if you saw it as contributing to your own medical emergency fund - it is no longer a choice, it has become a medical necessity.

 

Your body is telling you something is wrong with it. Don't ignore it. Your body is a smart little cookie.

Guys, guys, guys...I never said I was going to ignore it. I am still going to get checked out. It completely weirds me out that this happened and there's got to be a reason for it.

I will lecture you about the need for insurance after your are fixed. Try here, assuming your sig is accurate:

https://www.freeclinics.com/co/ks-shawnee

Thank you for that! I have been doing more research online about the resources and clinics in my area and I am finding more and more information. And yes you can lecture me about insurance. I promise I will look into it & consider my options for fitting in the expense. Good news is that my CC debt is paid off (for the 2nd time) as of this month. I just have one low interest debt left that will allow me an extra $200 by June. If it has to be tight until then, I'll make it work.

American health care is fucked up. This kind of thing is horrific and shameful. :(

Uh, no it's not anymore (with some caveats).  The OP could have gotten insurance but decided instead decided to "self-insure".

The OP says insurance will cost $300/month which she can't afford. You might argue about her budgeting and priorities but a system where monthly cost and/or cost of care is high enough that people are even considering rolling the dice on insurance or seeing a doctor when in severe pain surely meets my definition of shameful.

Idk, last year the OP indicated she made 50-55k/yr at her job.  Unless something has changed since then it seems something is amiss here.

$50K/year income, and she can't afford $4K/yr insurance?  I'm sorry, but she has enough money to buy insurance.

Umm...you are making assumption based on my income only. You don't know my other monthly payments, debts, or that I have another person in my house that I provide for. This post was to get helpful advice on where to start. That is all. I appreciate your concern but I do believe that $300/mo is excessive for something such as insurance and I do believe that our healthcare system is "fucked up". That doesn't mean I won't pay for it. I already planned on getting it now that I am in my 30s which is one reason I have been trying so hard to get rid of some of my debts. I certainly do not regret not having it up until this point.

[CharChar]

When you get insurance, have your gallbladder checked. Coffee can often cause gallbladder attacks, and chronic gallbladder issues can cause more problems than just the acute pain that stops when you cut the food.

Thank you. Even though the pain has subsided for now, it seemed to me like there would have to be a reason for it happening. I will definitely be bringing this up when I go get checked out.

You need to go to a regular internist or family practice doctor; an urgent care center will probably just send you to the ER. My wife has actually been having a very similar problem and you're pretty much the only person we've heard of with this combination of symptoms- significant pain only in the hours right before awakening that dissipates within a few minutes of getting up, but a longer term history of lower back pain. This type of pain is significantly concerning that you really need to go through some basic screening- blood work and urine tests, possibly an ultrasound or CT to check kidneys, liver, gallbladder, etc. In her case, everything came back fine, so she's doing physical therapy. She's seen some improvement, but it's still waking her up more days than not. Chronic musculoskeletal pain is extremely hard to deal with, but you first need to rule out problems with major organs that can be fixed, and could be life threatening if they're not addressed. Don't bother with specialists unless your PCP diagnoses something they can actually address.

Thank you, this is exactly the kind of advice I'm looking for. It really upsets me that someone might be going through the same thing or something similar because it is NOT fun and besides dealing with the pain itself, it has affected my mood, my emotions, etc. Does my coffee/Nyquil scenario make you think of anything that could be doing the same thing? I will keep you posted once I have tests ran. If they come back normal, it would seem that there could be something similar affecting your wife. Again thank you for sharing that with me. I hope she is able to find more permanent relief.

[Calvawt]

Before the ACA, when I was uninsured (had cancer while on COBRA, and then insurers wouldn't touch me), I went to an FQHC,  If you look "normal", they will not give you a discount off the rack rate, as they, in a strange sort of way, seem to have the same attitude that their sworn enemies the Republicans have on assistance to the "able-bodied".  That said, the rack rate is nowhere near as high as a standard practice, but the physicians there are only general practitioners.  I think the OP has no choice - if she wishes to get healthy and avoid a fatal disease - but to get checked up and pay whatever needs to be paid.

I don't think those are true statements.  FQHCs have primary care based physicians and mid-levels, which may vary by FQHC, but most still have some combination of FP, IM, and Peds.  "General practitioner" is a term for a physician that doesn't finish a US based residency program which is quite rare these days. 

They can also have specialists across a wide spectrum of fields like general surgeons, ENT, Endo, Gastro, etc.  If they don't have that specialty, then they often have built a referral network for those without commercial coverage. 

Also, they don't give discounts based on looks, just off of income and family size (federal law).

[Kakashi]

I'm an actual physician.  Here are my thoughts after reading through this thread (warning, a bit snarky):

- I love how internet people come up with completely random medical insights based on their individual experience that it's the "kidney" or it's the "gallbladder" because "this one time...".  (highlight the word "individual").  Based on OP's description, I have no idea what she has, since it doesn't sound like anything classic or obvious.   

- "Get to the ER now".  So cliche.  OP is the very type of person that the ER would bankrupt.  OP seems like has a decent paying job and conscientious about finances.  OP would get the full charge of the hospital ER and just hope they would negotiate with her afterwards.  Easily several thousand dollars.  OP without insurance is different than a homeless person without insurance. 

- Most of your urgent cares and pharmacy "minute clinics" are staffed by nurse practitioners and physician assistants.  And unless your symptoms are easily recognizable or fixed, they'll send you to the ER.  Most of them are a waste of money (unless you have something very straightforward, like a cold or a laceration). 

- If OP deems health insurance a priority, she would have it.  She doesn't and so she can't "afford it".  People think they're "fine" and "don't need health insurance" until something hits them out of the blue, like pain or an accident.  I hope for OP this is a wake up call. 

- A doctor visit honestly itself is pretty useless (unless your problem is straightforward).  You may budget $100 for a visit.  But to arrive at a diagnoses, you'll need tests.  Without insurance, good luck negotiating with Labcore or Quest Diagnostics, or your local imaging center, etc.

Back when I was making <$50K a year, and also healthy, I shelled out $1200/month for COBRA during a transition period of 1 month.  1 measly month and I wouldn't take the chance.  Because I've seen over and over the actual situations of healthy people getting something out of the blue.  While I don't wish harm on anyone, to those who make a conscious decision decide to skip on health insurance because they are "generally healthy", if something happens, I think there's a "serves you right" in order.

[swampwiz]

I guess you didn't get the memo after all - you do not have the luxury of putting off seeing a doctor.
You are still trading your health for money. We get why you might choose to do so, at least some of us anyway. Regardless, you can no longer afford not to have medical insurance. 
Good Luck, providence has seen fit to give you a warning, heed it, before you run out of time and end up in serious trouble.

Maybe it would help if you saw it as contributing to your own medical emergency fund - it is no longer a choice, it has become a medical necessity.

 

Your body is telling you something is wrong with it. Don't ignore it. Your body is a smart little cookie.

Guys, guys, guys...I never said I was going to ignore it. I am still going to get checked out. It completely weirds me out that this happened and there's got to be a reason for it.

I will lecture you about the need for insurance after your are fixed. Try here, assuming your sig is accurate:

https://www.freeclinics.com/co/ks-shawnee

Thank you for that! I have been doing more research online about the resources and clinics in my area and I am finding more and more information. And yes you can lecture me about insurance. I promise I will look into it & consider my options for fitting in the expense. Good news is that my CC debt is paid off (for the 2nd time) as of this month. I just have one low interest debt left that will allow me an extra $200 by June. If it has to be tight until then, I'll make it work.

American health care is fucked up. This kind of thing is horrific and shameful. :(

Uh, no it's not anymore (with some caveats).  The OP could have gotten insurance but decided instead decided to "self-insure".

The OP says insurance will cost $300/month which she can't afford. You might argue about her budgeting and priorities but a system where monthly cost and/or cost of care is high enough that people are even considering rolling the dice on insurance or seeing a doctor when in severe pain surely meets my definition of shameful.

Idk, last year the OP indicated she made 50-55k/yr at her job.  Unless something has changed since then it seems something is amiss here.

$50K/year income, and she can't afford $4K/yr insurance?  I'm sorry, but she has enough money to buy insurance.

Umm...you are making assumption based on my income only. You don't know my other monthly payments, debts, or that I have another person in my house that I provide for. This post was to get helpful advice on where to start. That is all. I appreciate your concern but I do believe that $300/mo is excessive for something such as insurance and I do believe that our healthcare system is "fucked up". That doesn't mean I won't pay for it. I already planned on getting it now that I am in my 30s which is one reason I have been trying so hard to get rid of some of my debts. I certainly do not regret not having it up until this point.

OK, so what would you do if your taxes went up 8% more of income?  This is an equivalent situation.  I bring up this point because the ACA gives you a premium tax credit (again with some caveats that need to get fixed) where your expected contribution is about that portion of income.  So a very understanding Democratic Congress figured that this was a fair amount to pay.  And even under the best of circumstances, any MediSomething-For-All fix would entail some type of increased revenue by the beneficiary, either in the way of a premium payment (as in the ACA) or by an increase in tax revenue - in essence, forcing folks to pay into the system - so you would be paying the amount that you claim that you can't afford.

I'm sorry, but after I went years without insurance because I was a cancer patient while on COBRA and then completely locked out of the individual insurance market, I have absolutely no tolerance for folks that refuse to buy insurance that they can afford.  If you are in such financial distress, I recommend filing for bankruptcy; even in Chapter 13, your health insurance premium - and any co-pays - will get the 2nd highest level of precedence (taxes are 1st).

Something else to try is to cyberbeg on GoFundMe.  Here is another person that decided to voluntarily self-insure and begged for money when he needed an expensive treatment to stop from going blind:

http://gawker.com/man-who-would-rather-go-blind-than-get-obamacare-now-go-1704019495

You can explain your total situation, and folks who can sympathize with you will donate.

Here's another article:

http://gawker.com/5991076/people-are-perfectly-willing-to-gamble-with-their-own-health-insurance-coverage

[swampwiz]

I'm an actual physician.  Here are my thoughts after reading through this thread (warning, a bit snarky):

- I love how internet people come up with completely random medical insights based on their individual experience that it's the "kidney" or it's the "gallbladder" because "this one time...".  (highlight the word "individual").  Based on OP's description, I have no idea what she has, since it doesn't sound like anything classic or obvious.   

- "Get to the ER now".  So cliche.  OP is the very type of person that the ER would bankrupt.  OP seems like has a decent paying job and conscientious about finances.  OP would get the full charge of the hospital ER and just hope they would negotiate with her afterwards.  Easily several thousand dollars.  OP without insurance is different than a homeless person without insurance. 

- Most of your urgent cares and pharmacy "minute clinics" are staffed by nurse practitioners and physician assistants.  And unless your symptoms are easily recognizable or fixed, they'll send you to the ER.  Most of them are a waste of money (unless you have something very straightforward, like a cold or a laceration). 

- If OP deems health insurance a priority, she would have it.  She doesn't and so she can't "afford it".  People think they're "fine" and "don't need health insurance" until something hits them out of the blue, like pain or an accident.  I hope for OP this is a wake up call. 

- A doctor visit honestly itself is pretty useless (unless your problem is straightforward).  You may budget $100 for a visit.  But to arrive at a diagnoses, you'll need tests.  Without insurance, good luck negotiating with Labcore or Quest Diagnostics, or your local imaging center, etc.

Back when I was making <$50K a year, and also healthy, I shelled out $1200/month for COBRA during a transition period of 1 month.  1 measly month and I wouldn't take the chance.  Because I've seen over and over the actual situations of healthy people getting something out of the blue.  While I don't wish harm on anyone, to those who make a conscious decision decide to skip on health insurance because they are "generally healthy", if something happens, I think there's a "serves you right" in order.

Thank you, Dr. Kakashki, for interjecting some wisdom here!

[swampwiz]

(Her husband has insurance but for some reason he can't get family coverage - really?)

Her husband's employer may refuse to offer coverage to the SO if the SO has coverage available through their own job, no matter how crappy and/or insanely expensive that might be for the other spouse or the couple together.

My husband's old employer had a policy like that. It wasn't a problem for us at the time because I was not working, but I can see how it would easily be a major PITA for other couples caught in that.

Sometimes they don't offer family coverage, sometimes it's just really expensive (>$1000/month)

Yeah, my old employer, when I was making 30k/year, offered family coverage for over $700/mo.  That was the price of our RENT.  And no distinction between insuring one other person or eight other people (or more).

The ACA has fixed this problem (I will presume that the $30K is your total income), as someone in this situation would be able to get coverage on the Exchange, and with a premium tax credit.

[swampwiz]

Before the ACA, when I was uninsured (had cancer while on COBRA, and then insurers wouldn't touch me), I went to an FQHC,  If you look "normal", they will not give you a discount off the rack rate, as they, in a strange sort of way, seem to have the same attitude that their sworn enemies the Republicans have on assistance to the "able-bodied".  That said, the rack rate is nowhere near as high as a standard practice, but the physicians there are only general practitioners.  I think the OP has no choice - if she wishes to get healthy and avoid a fatal disease - but to get checked up and pay whatever needs to be paid.

I don't think those are not true statements.  FQHCs have primary care based physicians and mid-levels, which may vary by FQHC, but most still have some combination of FP, IM, and Peds.  "General practitioner" is a term for a physician that doesn't finish a US based residency program which is quite rare these days. 

They can also have specialists across a wide spectrum of fields like general surgeons, ENT, Endo, Gastro, etc.  If they don't have that specialty, then they often have built a referral network for those without commercial coverage. 

Also, they don't give discounts based on looks, just off of income and family size (federal law).

Uh, yes they do.  It has happened to me twice, being a youthful, clean-cut, "able-bodied", white male American.  I probably should have filed a discrimination suit, but I didn't want to make waves.

[big_slacker]

Umm...you are making assumption based on my income only. You don't know my other monthly payments, debts, or that I have another person in my house that I provide for. This post was to get helpful advice on where to start. That is all. I appreciate your concern but I do believe that $300/mo is excessive for something such as insurance and I do believe that our healthcare system is "fucked up". That doesn't mean I won't pay for it. I already planned on getting it now that I am in my 30s which is one reason I have been trying so hard to get rid of some of my debts. I certainly do not regret not having it up until this point.

Didn't want to argue with folks after my statement since they were missing the point as evidenced by the character judgments and focus on the individual issue. Even in 2nd world countries where I've had to use the public system (everyone in the house are dual citizens except me) there wouldn't be a situation where someone is afraid to go to the ER or doctor because of out of pocket cost. I had to go to the ER at 8pm on a sunday in Warsaw because my toddler had some really scary problems on the flight over. As an American I was dreading an inevitable $1500+ bill. It cost me $40 out of pocket including the prescription we walked away with. When we talk to the in-laws about the medical stuff we deal with in the US they laugh at us.

[Paul der Krake]

Umm...you are making assumption based on my income only. You don't know my other monthly payments, debts, or that I have another person in my house that I provide for. This post was to get helpful advice on where to start. That is all. I appreciate your concern but I do believe that $300/mo is excessive for something such as insurance and I do believe that our healthcare system is "fucked up". That doesn't mean I won't pay for it. I already planned on getting it now that I am in my 30s which is one reason I have been trying so hard to get rid of some of my debts. I certainly do not regret not having it up until this point.

Didn't want to argue with folks after my statement since they were missing the point as evidenced by the character judgments and focus on the individual issue. Even in 2nd world countries where I've had to use the public system (everyone in the house are dual citizens except me) there wouldn't be a situation where someone is afraid to go to the ER or doctor because of out of pocket cost. I had to go to the ER at 8pm on a sunday in Waraw because my toddler had some really scary problems on the flight over. As an American I was dreading an inevitable $1500+ bill. It cost me $40 out of pocket including the prescription we walked away with. When we talk to the in-laws about the medical stuff we deal with in the US they laugh at us.

Yes, the system sucks. You know it, I know it, OP knows it. We all know this.

That doesn't absolve OP from responsibility. She rolled the dice for over a decade (and breaking the law for the last couple years when coverage became mandatory), and despite the current trouble will probably come out ahead when the dust settle.

There's no way to sugarcoat it, it was downright reckless and irresponsible considering her income level.

[CharChar]

Look, I can afford insurance if I want to. I have chosen to spend the last couple of years getting my finances in order. Paying for insurance that whole time would not have allowed me to do so and would have been a waste of $3600. Yes my yearly gross income is about $55k. But I only went to that salary less than 2 years ago, from $35k. I made a personal plan to get rid of my debts and then pay for insurance. So, Murphy's Law says that I have to have a medical problem just before my plan plays out. Go figure. But I made this decision and I stand by it and I'm sorry but no one else is covering my costs. Anything medical related that I have had to pay for, I have done without loans or CCs or assistance.

The point is, I can pay for what I need to. If I need to come up with several hundred dollars, I can move some stuff around. I can make a payment plan for certain services. I can borrow the money from my mother at no interest if I really need to or get a zero interest CC to help cover costs. I also know that, as of right now, I can still get insurance at any time, even if I'm diagnosed with something. When I say I can't spend another $300/mo, I mean it. But I could reduce expenses else where if I had to, which would still make things very tight.

My monthly expenses are about to decrease by several hundred dollars and I'm not going to let anything get in the way of that if I don't have to. I realize those expenses could be replaced with medical bills or will be replaced with insurance payments and I'm ok with that because at least then I have no other unnecessary debts/payments to worry about. I also understand I am taking a risk. But its my risk to take.

I don't know how this turned into a thread about bashing people who can afford insurance but choose not to have it. Last I checked, I had the right to do so. This post was to get suggestions on what kind of doctor/clinic to start with based on what's going on with me and the fact that I do not have insurance. I am well aware of what I am doing and appreciate those who can respect that.

[kite]

OP  -- is there a Planned Parenthood near you?  I've had many friends use them for primary care when between insurance and even with insurance. My nearest one definately has a sliding scale fee structure. 
The thing is, any competent doctor will need to rule out gynecologic issue as being the source of your pain.  You might as well get that sorted without delay. 

[CharChar]

Umm...you are making assumption based on my income only. You don't know my other monthly payments, debts, or that I have another person in my house that I provide for. This post was to get helpful advice on where to start. That is all. I appreciate your concern but I do believe that $300/mo is excessive for something such as insurance and I do believe that our healthcare system is "fucked up". That doesn't mean I won't pay for it. I already planned on getting it now that I am in my 30s which is one reason I have been trying so hard to get rid of some of my debts. I certainly do not regret not having it up until this point.

Didn't want to argue with folks after my statement since they were missing the point as evidenced by the character judgments and focus on the individual issue. Even in 2nd world countries where I've had to use the public system (everyone in the house are dual citizens except me) there wouldn't be a situation where someone is afraid to go to the ER or doctor because of out of pocket cost. I had to go to the ER at 8pm on a sunday in Waraw because my toddler had some really scary problems on the flight over. As an American I was dreading an inevitable $1500+ bill. It cost me $40 out of pocket including the prescription we walked away with. When we talk to the in-laws about the medical stuff we deal with in the US they laugh at us.

Thank you

Umm...you are making assumption based on my income only. You don't know my other monthly payments, debts, or that I have another person in my house that I provide for. This post was to get helpful advice on where to start. That is all. I appreciate your concern but I do believe that $300/mo is excessive for something such as insurance and I do believe that our healthcare system is "fucked up". That doesn't mean I won't pay for it. I already planned on getting it now that I am in my 30s which is one reason I have been trying so hard to get rid of some of my debts. I certainly do not regret not having it up until this point.

Didn't want to argue with folks after my statement since they were missing the point as evidenced by the character judgments and focus on the individual issue. Even in 2nd world countries where I've had to use the public system (everyone in the house are dual citizens except me) there wouldn't be a situation where someone is afraid to go to the ER or doctor because of out of pocket cost. I had to go to the ER at 8pm on a sunday in Waraw because my toddler had some really scary problems on the flight over. As an American I was dreading an inevitable $1500+ bill. It cost me $40 out of pocket including the prescription we walked away with. When we talk to the in-laws about the medical stuff we deal with in the US they laugh at us.

Yes, the system sucks. You know it, I know it, OP knows it. We all know this.

That doesn't absolve OP from responsibility. She rolled the dice for over a decade (and breaking the law for the last couple years when coverage became mandatory), and despite the current trouble will probably come out ahead when the dust settle.

There's no way to sugarcoat it, it was downright reckless and irresponsible considering her income level.

Excuse me?? Really? I should feel bad because I'm "breaking the law"?? Hahaha! Seriously now. And I don't see insurance as a responsibility. I see insurance is an industry. Because that's what it is.

[CharChar]

OP  -- is there a Planned Parenthood near you?  I've had many friends use them for primary care when between insurance and even with insurance. My nearest one definately has a sliding scale fee structure. 
The thing is, any competent doctor will need to rule out gynecologic issue as being the source of your pain.  You might as well get that sorted without delay.

Yes and that is a very good point that I did not think of. Thank you!

[Laura Ingalls]

People posting on this thread get your plan.  They may have even done something similar in the past.  That does not make your plan a good idea. They are not respecting your plan because it is massively short sighted.  You are one ruptured appendix from bankruptcy because you are unwilling to spend 6% of your income on health insurance.  It’s easy to argue your current plan makes sense if everything goes perfect.  My own experience and my observation of others is that that is rarely the case.  I am going to guess that you debt situation occurred in the first place because you expected something to work out that didn’t?

[big_owl]

Excuse me?? Really? I should feel bad because I'm "breaking the law"?? Hahaha! Seriously now. And I don't see insurance as a responsibility. I see insurance is an industry. Because that's what it is.

I think the blowback you are getting boils down to this:

1. The only way insurance works is for those who don't need it (i.e., are healthy) to pay in regularly to support those who do need it.  And that includes your future self as your health inevitably fails.

2. You've chosen to forgo insurance even though, as you just stated above, you could have afforded it if you wanted to but since the fine was cheaper that's what you've done.  In the meantime the rest of us, who do pay, are paying more because of people like you who "could afford it if they wanted to" but choose not to.

3. Now you're here with "no insurance, no clue..."

Like you said, it's your risk to take (with the help of the actual ratepayers' dollars of course).  And we can judge :)

[Paul der Krake]

Excuse me?? Really? I should feel bad because I'm "breaking the law"?? Hahaha! Seriously now. And I don't see insurance as a responsibility. I see insurance is an industry. Because that's what it is.

You can act all offended, but this isn't up for debate. If you chose to go without coverage in the years where the ACA individual mandate was in effect, you were breaking the law, regardless of your views what insurance should or should not be.

This is an open forum, and we don't blindly give deference to individuals' choices when they are silly. Had you come here with a story about how you hit someone with your car while driving without insurance, looking for a cheap/free attorney, people would not have been so nice. I'm ripping into you as a cautionary tale to others who may be tempted of rolling the dice, not because I have something against you personally.

You've been given plenty of good advice in this thread, and I wish you a speedy resolution and recovery. Hopefully you will learn something from this.

[BlueHouse]

Look, I can afford insurance if I want to. I have chosen to spend the last couple of years getting my finances in order. Paying for insurance that whole time would not have allowed me to do so and would have been a waste of $3600. Yes my yearly gross income is about $55k. But I only went to that salary less than 2 years ago, from $35k. I made a personal plan to get rid of my debts and then pay for insurance. So, Murphy's Law says that I have to have a medical problem just before my plan plays out. Go figure. But I made this decision and I stand by it and I'm sorry but no one else is covering my costs. Anything medical related that I have had to pay for, I have done without loans or CCs or assistance.

The point is, I can pay for what I need to. If I need to come up with several hundred dollars, I can move some stuff around. I can make a payment plan for certain services. I can borrow the money from my mother at no interest if I really need to or get a zero interest CC to help cover costs. I also know that, as of right now, I can still get insurance at any time, even if I'm diagnosed with something. When I say I can't spend another $300/mo, I mean it. But I could reduce expenses else where if I had to, which would still make things very tight.

My monthly expenses are about to decrease by several hundred dollars and I'm not going to let anything get in the way of that if I don't have to. I realize those expenses could be replaced with medical bills or will be replaced with insurance payments and I'm ok with that because at least then I have no other unnecessary debts/payments to worry about. I also understand I am taking a risk. But its my risk to take.

I don't know how this turned into a thread about bashing people who can afford insurance but choose not to have it. Last I checked, I had the right to do so. This post was to get suggestions on what kind of doctor/clinic to start with based on what's going on with me and the fact that I do not have insurance. I am well aware of what I am doing and appreciate those who can respect that.

(Emphasis is mine)
@CharChar -- can you provide more info on the bold?  How is this done?

[boarder42]

This is one area someone should not be trying to save a buck in by carrying no insurance at all.  The financial ramifications are devastating to any well laid plan and are not within your control to some level.  The state of the current healthcare system in this country makes the choice you're making wildly dumb.  And to sit here and negate all of the people offering you free advice b/c you understand this risk doesnt change the fact that the risk is overwhelming bad if it ever gets there.  You currently just waited out some pain you called excruciating, there is a certain level of to each their own but self insuring for healthcare at your low level of assets is a recipe for disaster. 

should the medical system be fixed and more accessible to those who want to self insure up to a certain dollar amount yes - should we have a universal payer here - yes. 

I'm one of those here who sides on the riskier sides of most debates but not carrying health insurance in the US is a very poor financial decision regardless of your age or current health conditions;.

[FIRE47]

This is the reason people don't take this community seriously as a whole.

Someone is willing to die in horrific pain to try to save a few bucks....

[jim555]

This is the reason people don't take this community seriously as a whole.

Someone is willing to die in horrific pain to try to save a few bucks....

I don't think this example applies to the community in general.  Most here have some kind of health coverage or responsible backup plan for medical events.

[Richie Poor]

There is not a law that forces you to have insurance. There is only a tax for people that do not have insurance. The uninsured are not criminals.

I've always been self employed so when I was younger I did not have insurance. I still don't have it now but belong to a healthcare sharing ministry and that has worked out pretty well. As such I do end up paying cash for my family's medical care.

I've noticed two ways to save money. You can always negotiate bills with hospitals after the fact and set up payment plans. It can still be pretty expensive but not as bad as the initial sticker shock bill they send. Another option a lot of hospitals have is financial assistance for those that qualify. This can knock off 80 or 90%. Since my bills were reimbursed I didn't need the financial assistance but I was surprised that I qualified. The income limits might be higher than you think.

If insurance were not an option, I think the cheapest way to get a diagnosis for the OP might be a Direct Primary Care physician. They don't take insurance and they usually have really good negotiated rates for labwork. You just pay a monthly fee of $50-$60. My wife loves her Direct primary care doctor. He spends about an hour with her on every visit and will text her sometimes to follow up. And we no longer have to pay a few hundred dollars to Quest Diagnostics to run blood tests. If the test were to show that you had something very terribly wrong with you though you would wish you had insurance or something like it.

You can join the ACA if you have any "life events" outside of the enrollment period. Maybe get married sometime this week?

[CharChar]

 

This is the reason people don't take this community seriously as a whole.

Someone is willing to die in horrific pain to try to save a few bucks....

Again, seriously? Now you are calling me cheap?! I think your being a bit of a drama queen. I'M the reason people don't take this seriously? C'mon! MMM himself has articles about insurance where he debates this very topic. If its debatable, there must not be 1 right answer, right? Sorry but I just don't think these types of comments are worthy of this post or this community. I am responsible because I DO have back up plans. My plans have simply not included insurance payments.

I like how people always try to turn these posts into something else. We all know the people of this community deserve face punches for various things. There are very few who do not. The fact that you continue when this is MY problem and I've asked you to stop just shows that you like to argue. And its not like its productive arguing.

So could we please get back on track? Or could those who have their panties in a wad drop off the face of this post? That would be great thanks!

[swampwiz]

Yes, the system sucks. You know it, I know it, OP knows it. We all know this.

That doesn't absolve OP from responsibility. She rolled the dice for over a decade (and breaking the law for the last couple years when coverage became mandatory), and despite the current trouble will probably come out ahead when the dust settle.

There's no way to sugarcoat it, it was downright reckless and irresponsible considering her income level.

Technically, she was not breaking the law; she was only incurring an additional "tax" liability.

[FIRE47]

This is the reason people don't take this community seriously as a whole.

Someone is willing to die in horrific pain to try to save a few bucks....

Again, seriously? Now you are calling me cheap?! I think your being a bit of a drama queen. I'M the reason people don't take this seriously? C'mon! MMM himself has articles about insurance where he debates this very topic. If its debatable, there must not be 1 right answer, right? Sorry but I just don't think these types of comments are worthy of this post or this community. I am responsible because I DO have back up plans. My plans have simply not included insurance payments.

I like how people always try to turn these posts into something else. We all know the people of this community deserve face punches for various things. There are very few who do not. The fact that you continue when this is MY problem and I've asked you to stop just shows that you like to argue. And its not like its productive arguing.

So could we please get back on track? Or could those who have their panties in a wad drop off the face of this post? That would be great thanks!

I honestly can't decide if this whole post is just a bad troll job trying to make a mockery of MMM taken to an extreme. Seriously? You're in excruciating pain and trying to get a diagnosis on MMM to save money instead of going to a doctor?

GO TO A DOCTOR RIGHT NOW

[swampwiz]

Anything medical related that I have had to pay for, I have done without loans or CCs or assistance.

The point is, I can pay for what I need to. If I need to come up with several hundred dollars, I can move some stuff around. I can make a payment plan for certain services. I can borrow the money from my mother at no interest if I really need to or get a zero interest CC to help cover costs. I also know that, as of right now, I can still get insurance at any time, even if I'm diagnosed with something. When I say I can't spend another $300/mo, I mean it. But I could reduce expenses else where if I had to, which would still make things very tight.

My monthly expenses are about to decrease by several hundred dollars and I'm not going to let anything get in the way of that if I don't have to. I realize those expenses could be replaced with medical bills or will be replaced with insurance payments and I'm ok with that because at least then I have no other unnecessary debts/payments to worry about. I also understand I am taking a risk. But its my risk to take.

I don't know how this turned into a thread about bashing people who can afford insurance but choose not to have it. Last I checked, I had the right to do so. This post was to get suggestions on what kind of doctor/clinic to start with based on what's going on with me and the fact that I do not have insurance. I am well aware of what I am doing and appreciate those who can respect that.

OK, Ms Money Moustasche, do you think that "several hundred dollars" will pay for a standard stage 2 cancer treatment?  What would you do then?  Just suck it up until you can buy an ACA plan?  Or perhaps get treated and wind up with a big bill and then file for bankruptcy?  Quit your job and move to another state and go on Medicaid?  It's folks like you that have really made the ACA painful, and politicians - in both parties - have been too timid in letting folks play the system.

[jim555]

Is it really realistic to quit your job or move in a health event?  Not really.  Maybe if you are FIREd you could move since a job is not a consideration.  Even then you would need enough to cover two months of hospitalization.  That might be enough to totally end your FI stash and dreams.

[Kakashi]

This is the reason people don't take this community seriously as a whole.

Someone is willing to die in horrific pain to try to save a few bucks....

Again, seriously? Now you are calling me cheap?! I think your being a bit of a drama queen. I'M the reason people don't take this seriously? C'mon! MMM himself has articles about insurance where he debates this very topic. If its debatable, there must not be 1 right answer, right? Sorry but I just don't think these types of comments are worthy of this post or this community. I am responsible because I DO have back up plans. My plans have simply not included insurance payments.

I like how people always try to turn these posts into something else. We all know the people of this community deserve face punches for various things. There are very few who do not. The fact that you continue when this is MY problem and I've asked you to stop just shows that you like to argue. And its not like its productive arguing.

So could we please get back on track? Or could those who have their panties in a wad drop off the face of this post? That would be great thanks!

But it's not just your problem.

What you don't recognize (and what others do) is that people like you that are trying to game the system drive up costs for everyone else.  So your risk is not just your own.  Millions of others just like you feel they don't need insurance, and can just jump on board when they have something wrong.  Healthcare is a different argument than other areas.  Sure if you end up in the ER and incur a $5K bill, that's all on you.  However, I'm thinking the most likely worst case for a younger person with abd pain is a ruptured ulcer.  It carries a high mortality rate.  If you have a ruptured ulcer, are you going to say "despite all this pain, despite I'm going to die, I didn't buy health insurance and I'm just going to stay at home and die".  Nope, you're going to goto ER, get admitted to ICU for days, undergo major surgery, etc.  Probably rack up a bill of $200K. 

Are you going to say, "ok I'll dedicate the next 15 years of life paying off this bill because I took the risk and incurred it".  Nope, you'll probably declare bankruptcy.  So now the hospital foots that bill.  The hospital then turns around and raises its charges to cover for you.  Then next year, you sign up for insurance, and now they have to cover a pre-existing condition and it drives up their cost, and they in turn raises premiums across the board. 

Now if we were in another country, where "if you can't pay, then oh well we can't treat you even if you are dying", then you're right, it is just your own risk.  It affects no one else.  And the argument would just be an academic one about personal finances. 

I hope everyone gaming the system gets hit by the system.  Not catastrophic stuff, but just enough to make them understand that it was a stupid decision and it won't affect anyone else.  Like if they hoped to save $3600, I hope they get hit with a ER bill for $5K. 

[JumpInTheFIRE]

I'm an actual physician.  Here are my thoughts after reading through this thread (warning, a bit snarky):

- I love how internet people come up with completely random medical insights based on their individual experience that it's the "kidney" or it's the "gallbladder" because "this one time...".  (highlight the word "individual").  Based on OP's description, I have no idea what she has, since it doesn't sound like anything classic or obvious.   

- "Get to the ER now".  So cliche.  OP is the very type of person that the ER would bankrupt.  OP seems like has a decent paying job and conscientious about finances.  OP would get the full charge of the hospital ER and just hope they would negotiate with her afterwards.  Easily several thousand dollars.  OP without insurance is different than a homeless person without insurance. 

- Most of your urgent cares and pharmacy "minute clinics" are staffed by nurse practitioners and physician assistants.  And unless your symptoms are easily recognizable or fixed, they'll send you to the ER.  Most of them are a waste of money (unless you have something very straightforward, like a cold or a laceration). 

- If OP deems health insurance a priority, she would have it.  She doesn't and so she can't "afford it".  People think they're "fine" and "don't need health insurance" until something hits them out of the blue, like pain or an accident.  I hope for OP this is a wake up call. 

- A doctor visit honestly itself is pretty useless (unless your problem is straightforward).  You may budget $100 for a visit.  But to arrive at a diagnoses, you'll need tests.  Without insurance, good luck negotiating with Labcore or Quest Diagnostics, or your local imaging center, etc.

Back when I was making <$50K a year, and also healthy, I shelled out $1200/month for COBRA during a transition period of 1 month.  1 measly month and I wouldn't take the chance.  Because I've seen over and over the actual situations of healthy people getting something out of the blue.  While I don't wish harm on anyone, to those who make a conscious decision decide to skip on health insurance because they are "generally healthy", if something happens, I think there's a "serves you right" in order.

So to sum up your post, the ER is useless, urgent care is useless and a physician visit is useless.  What exactly do you suggest for the OP if not an ER, urgent care or office visit? Find a specialist for an undefined condition?

[FIRE Artist]

This is the reason people don't take this community seriously as a whole.

Someone is willing to die in horrific pain to try to save a few bucks....

Agreed.  I think this thread should be moved to the Antimustachian wall of shame.

[grantmeaname]

Let’s not pile on. I think it’s clear the OP gets it and has also gotten a few actually helpful tips from people. Kicking her one more time isn’t really going to change things.

[FIRE Artist]

So to sum up your post, the ER is useless, urgent care is useless and a physician visit is useless.  What exactly do you suggest for the OP if not an ER, urgent care or office visit? Find a specialist for an undefined condition?

I read this to mean that you likely are not going to get a diagnosis on a single doctor visit, that the OP will likely need tests and possibly more follow up tests.

[Rogue Dad, M.D.]

I think you've received some good advice from the other physicians who've chimed in.

As an ER doc, it sounds like you could start off at a true primary care physician.

You can negotiate both bills with the primary care doc, go to an outpatient lab that is lower cost and negotiate a cheaper cash price, and do the same for imaging you may need (xray, CT, MRI).  You can pick labs and imaging centers that are lower cost than those directly attached to a hospital, which will cost more.

However this is still could cos you several hundred dollars, ie the cost of insurance for at least a few months.  I will add -- yes, you need insurance. 

If you have cancer, $300/month is going to be a drop in the bucket compared to the cost of everything else. The system sucks and the pricing/costs are ridiculous -- I fully agree (and have written about that more than once on my own blog).

But  I heartily disagree with MMM's take on insurance.  Being healthy isn't a reason to not get insurance. 

However having a huge nest egg with a huge amount of passive income and tiny fixed expenses are why he can get away w/o insurance if he chooses.  Even then, if he gets run over during a bike ride and needs chronic care for 40-50 years due to a major brain injury, he will need a 7 figure sum to cover the costs.  If you have cancer and need multiple surgeries and chemo and hospital stays before your insurance kicks in, that's a 6-figure sum.

Just like auto and other types of insurance, health insurance can be used for catastrophic care only if you want it to be (particular with ACA changes coming up). 

Best of luck with whatever is ailing you -- I hope you are able to get to the bottom of it and avoid any financial pitfalls on the way.

[kite]

I have three loved ones who did not sign up for any ACA plan.  One got melanoma another got throat cancer.  The third had cervical dysplasia (pre-cancer of the cervix).  The third was treated by PP and they worked a payment plan that was income based.  I knew that PP will handle some of what the OP has neglected and advised starting there. 
While I've got 2 other loved ones for whom we needed to pay thousands for thei PET scans, surgeons, etc, I won't join the pile on with woulda, shoulda, coulda because that doesn't help this poster or anyone else in a similar situation.  If you were in the US with an expired visa or just here legally and visiting, you could find yourself in a similar predicament.  Likewise if you are traveling where your insurance is useless.   "Where can I go?" is a fair question that should get answered with useful information, not a scolding. 

[big_owl]

I hope everyone gaming the system gets hit by the system.  Not catastrophic stuff, but just enough to make them understand that it was a stupid decision and it won't affect anyone else.  Like if they hoped to save $3600, I hope they get hit with a ER bill for $5K.

Really?  Shame on you.  The OP isn't particulary saavy when it comes to forward thinking, but she doesn't deserve to get hit with an ER bill of $5k, implying significant pain and suffering.  And while she's actively working against the common good of health care for all, she's ultimately not the reason we are where we are today.  Oh no, you are.  You're a much bigger part of the problem than she is. So you can spare us your bullshit rhetoric.   I'm the proud owner of not one, not two, but three chronic pain conditions.  From the waist down I've been in pain 24/7/365 for years.  I deal with your healthcare billing bullshit on a weekly basis.  If you have an ounce of compassion you don't wish something like that on anyone, no matter how annoying you find them.

[Kakashi]

I hope everyone gaming the system gets hit by the system.  Not catastrophic stuff, but just enough to make them understand that it was a stupid decision and it won't affect anyone else.  Like if they hoped to save $3600, I hope they get hit with a ER bill for $5K.

Really?  Shame on you.  The OP isn't particulary saavy when it comes to forward thinking, but she doesn't deserve to get hit with an ER bill of $5k, implying significant pain and suffering.  And while she's actively working against the common good of health care for all, she's ultimately not the reason we are where we are today.  Oh no, you are.  You're a much bigger part of the problem than she is. So you can spare us your bullshit rhetoric.   I'm the proud owner of not one, not two, but three chronic pain conditions.  From the waist down I've been in pain 24/7/365 for years.  I deal with your healthcare billing bullshit on a weekly basis.  If you have an ounce of compassion you don't wish something like that on anyone, no matter how annoying you find them.

ER visit, labs, meds, CT scan probably will rack up a charge of $5K.  Charge is the key word here and what will be billed to anyone who doesn't have insurance. 

But overall why not?  Someone tried to save $3600 instead ends up paying $5K.  I think that's a minor enough situation but can teach a lesson.  It will make them think that they should have just gotten insurance in the 1st place.  I'm not actually trying to wish anyone a horrible medical condition, but rather a small lesson in future and financial planning.

Oh and it's not "my" healthcare billing bs.  It's the way the US system works.  It sucks and messed up, but it is what it is. 

[Nate79]

Not sure what is the point of this thread. Go to the doctor and get a proper diagnosis. Someone is dumb as rocks if they take medical advice off of an internet forum like this from random strangers.



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[CharChar]

I'm done. I thought this was suppose to be a community of support. Guess I was wrong. I don't care what you all think of me or what I'm doing. The issue you are trying to argue about was not the topic of this post. I already know that I've done everything wrong in life and I'm trying to fix things but....man fuck you all for being such pieces of shit to someone who was asking for help. I won't be coming back to this post so don't bother.

[boarder42]

interesting response to some constructive critism .   

[FrugalToque]

[LOCKED - I feel like this topic is done.]