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No Health Insurance? Get Help Here

02.12.2009CNN.com

By Elizabeth Cohen
CNN Senior Medical Correspondent

(CNN) — Dr. John Di Saia was playing baseball with his son a few weeks ago, and just as he rounded second base, he tumbled to the ground, breaking his fall with his elbow.

“Guess I shouldn’t have been running in flip-flops,” says Di Saia. At first he didn’t think much of the injury, but as it became more painful, he showed it to a colleague, who told him he’d ruptured his triceps tendon. “He said I needed surgery immediately.

One problem: Di Saia, a plastic surgeon in San Clemente, California, didn’t have health insurance; he’d ended one policy a few weeks before and was about to start a new one. “It’s pretty embarrasing when you’re a physician and you say you don’t have health insurance. They think you’re some kind of an idiot,” he says.

Once he got over the embarrassment, Di Saia buckled down and negotiated with doctors and the outpatient clinic to get the price for his surgery cut in half, from $4,800 to $2,400. While he says he was clearly at an advantage being a doctor, he thinks everyone can — and should — negotiate health care costs if they don’t have insurance.

“You should always ask. Why wouldn’t you try?” he says.

Negotiating with doctors and hospitals is just one thing you have to learn how to do when your insurance disappears, says Steve Luptak, executive director of an assistance group called Healthcare Advocacy. “I’ve had so many people who’ve just been laid off coming to me for help because they’ve lost their insurance. They’re so stressed, they’re so depressed, they feel like it’s the end of the world,” he says. “But there are things you can do. It’s not a futile situation,” he says.

If you want to try to get new, affordable insurance, or find programs that offer you financial help for doctor’s visits, prescription drugs and more, follow these steps:

Step 1: Get good advice
When you get laid off and lose your health insurance, you may need someone in your corner. Several places specialize in helping people find new, affordable insurance and free care:

Healthcare Advocacy
Patient Advocate Foundation
Patient Services Incorporated

Step 2: Search for affordable insurance
With advice from experts at the groups above, begin your search for affordable insurance. Start with COBRA, which means you continue with your employer’s insurance, except now you’re paying the entire premium on your own. You can learn about COBRA at the Department of Labor’s Web site.

If you can’t afford to go on COBRA, you’re in good company; a recent study by the Commonwealth Fund found that only nine percent of people who are offered COBRA actually use it. Sometimes it’s less expensive to buy your own insurance policy rather than going on COBRA. You can compare prices at ehealthinsurance.com.

Step 3: Get your child on SCHIP
Even if you have too much money to qualify for Medicaid, your children may qualify for SCHIP, the State Children’s Health Insurance Program. Here’s a state-by-state directory of SCHIP programs.

There are other government programs, too. Your entire family may qualify for insurance from a state high-risk pool if you live in a state that has one.

If you think you might quality for Medicaid, see this state-by-state Medicaid directory.

Step 4: Get help with prescription drugs
If you can’t afford health insurance — or if your insurance doesn’t include good prescription drug benefits — look for $4 generic drugs at many major supermarkets and drug stores. Also, your state may offer a discount drug program (after you click, scroll down to see Table 2). You can also check these private groups that offer prescription assistance.

HealthWell Foundation
FamilyWize discount drug card
Needy Meds
Rx Assist
Rx Hope
Chronic Disease Fund
Partnership for Prescription Assistance
The Access Project

Step 5: Find financial assistance for your particular disease
Many diseases have specific foundations that offer financial assistance.
Heart Disease: Heart Support of America
Kidney Disease: American Kidney Fund
HIV/AIDS: The Access Project
Hepatitis: The Access Project
Cancer: see this Empowered Patient for a list of services
Alpha-1 Antitrypsin Deficiency, Chronic Granulomatous Disorder, Huntington’s Disease, Idiopathic Pulmonary Fibrosis, and Pulmonary Arterial Hypertension: Caring Voice Coalition
Other rare diseases: National Organization for Rare Diseases
Vision Care: EyeCare America and Vision USA

Step 6: Find free clinics
Federally funded health centers offer free care in both urban and rural areas. Put in your address here and find one near you.

Step 7: Consider a part-time job
Being a barista may not be your career dream, but working at Starbucks might be a smart move while you’re looking for something in your own field. Here is a list of employers who offer health insurance to part-timers (including Starbucks).