insurance

Dealing without health insurance

Tap into prescription assistance programs. Wiltz also recommends prescription assistance programs offered by Partnership for Prescription Assistance or by pharmaceutical companies.

Look into foundations and charities. Disease-specific foundations, charities or advocacy groups are great resources for free care or referrals.

Use retail health clinics. Some pharmacies and big-box retail stores include clinics, staffed by nurse practitioners who can help with smaller health matters (such as sore throats, earaches and vomiting).

Leverage health fairs. Look for community health fairs that offer free or low-cost screenings, sometimes including mammograms, pap smears, blood work, eye exams and such.

Ask your current doctor for cash-payment rates. Some private physicians and medical service providers offer lower cash-payment rates to people without insurance.

2 ways to avoid the emergency room trap

The Emergency Medical Treatment and Labor Act, or EMTALA, made it illegal for hospitals to refuse to help people in medical need based on ability to pay. Unfortunately, uninsured people sometimes end up in the ER because a lack of routine care pushes their bodies to the brink or because they feel as if they have nowhere else to go, even for routine medical concerns.

A study done by the National Association of Community Health Centers found that Americans waste $18 billion a year on unnecessary ER visits. Because hospitals charge the uninsured significantly higher rates than the rates that insurance companies pay, Davis Liu, M.D., author of "Stay Healthy, Live Longer, Spend Wisely," says, "Never ever use the emergency room for routine medical care."

ERs handle life or limb-threatening injuries or conditions. Always go to the ER in these situations. However, you have other options for scenarios of an imminent, but not emergency, nature.

Call your doctor, community health center or hospital advice line. The on-call doctor or nurse can help determine if your symptoms warrant a trip to the ER, an urgent care facility or some medications to tide you over until you can be seen in a normal clinical setting.

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Visit an urgent care clinic. These clinics address immediate medical needs other than life or limb-threatening problems. They are typically open when regular doctors' offices are closed.

5 ways to negotiate medical bills

Getting by without insurance means facing medical expenses without a contract dictating how much providers can charge. Levi Smith, CEO of The Karis Group, which negotiates medical bills for self-pay patients from private benefit plans, compares medical costs for the uninsured to rates hotels post on the back of doors that no one actually pays. But in a medical scenario, you just might. When asked about the fairness (or lack thereof) of such pricing policies, eHealthInsurance.com's Gibbs offers this comparison: Two people on the same plane to the same location may pay vastly different rates.

Within the last three or four years, however, medical service providers have become more lenient and proactive when working with uninsured or self-pay patients. Clarifications on federal programs resolved some providers' worries. "The concern that providers had before was that if they did one-off pricing for individuals, it would potentially jeopardize their reimbursement rates from Medicare and Medicaid or from contracted insurance organizations," says Smith.

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