I have a question about access to healthcare for the uninsured

[Ilsa]

Let's say you have cancer, maybe prostate cancer, and you are a man, maybe 55 years old. So this would be considered an aggressive cancer given his age.

What are his options for healthcare if he lost his job and cannot afford insurance or surgery? Does he go on a waiting list? Don't some states limit their Medicaid coverage?

[cbayer]

1. Most states (if not all) work on a spend-down program.

You are expected to pay for your own services until you get poor enough to qualify for medicaid.

Once that happens, medicaid starts picking up the bill.

Also, if someone becomes disabled from their medical illness and meets the criteria for social security disability, they will also qualify for medicare.

[Cleita]

2. I know people who have given all their assets to their children other than

the bare allowable assets so that they can qualify for Medicaid, which is better than nothing. Unfortunately, most doctors don't want to take Medicaid so if you are lucky enough to be near a clinic that takes care of the poor, you might be all right. Otherwise, you are stuck with the doctor who is forced to take Medicaid because he has issues, like alcoholism or too many malpractice lawsuits.

[cbayer]

4. FWIW, in the states I am familiar with, giving away your assets is verboten.

Also, medicaid reimbursement is the primary reasons that many physicians don't take it, or limit the number in their practices.

[Cleita]

9. Really, because all those trust fund babies couldn't be that if

daddy or granddad didn't transfer assets to them. There is a way through trusts to do it in CA anyway. Also, about doctors who take Medicare, I don't believe I said otherwise. Low reimbursement is why most doctors won't take it but there are clinics, in my area anyway, who do because they take care of the poor.

[cbayer]

11. I'm sorry. Let me clarify.

It is not allowed to give away your assets in order to become eligible for medicaid.

It is, of course, allowed to give away your assets under other circumstances.

[KT2000]

6. At least in WA state

assets transferred within a particular time frame will be recovered from the person(s) assets were transferrd to.

[Cleita]

10. I guess there is always a way to screw the working class, the people who might need to do something

like this just so they can get health care and so they can leave some of their hard earned assets to their children.

[KT2000]

13. Yep - once you get the

nursing home and the state involved in digging out the last penny - and I do mean last penny - you are done for.

[pinto]

3. Suggest he speak with the MD who made the dx and a local Medicaid rep in his state, as a start.

Documentation is often a key to accessing health care under Medicaid or other health care programs. That includes financial as well as medical info.

[MiniMe]

5. It partly depends on where you live

What state. Some states actually care, some don't. Hope he doesn't live in Texas

[Ilsa]

7. This was an example...

I was trying to make a point to someone about being able to get treated at an ER, but not necessarily being able to get follow-up care and treatment, such as chemotherapy.

Is an uninsured person guaranteed treatment such as chemo?

[cbayer]

8. No they are not.

While federal law requires that emergencies be seen and stabilized, there is not such requirement regarding follow up care.

There may be a state or locally funded program for chemo, but no one is "entitled" to it.

Outrageous, isn't it.

[blondie58]

12. my guy just got some sort of coversge

He qualified for the indigent care, not having insurance or a job. This is in Colorado and I am so happy for this. He is having some sciatic nerve pain, which we found out was due to a couple of bulging discs. He is trying physical therapy first with a $7 co-pay. He was able to get some good drugs, also, as he has been in a lot of pain.

[Sgent]

14. This really depends on the state

He *might* qualify for Medicaid, but only after he has spent down all his assets -- and about half the states must be 100% disabled (so sick he can't work).

Some cancers have a better outlook, for instance the breast & cervical cancer program in most states will treat the disease. Ryan White act will treat HIV / AIDS, etc.

There is no requirement that any oncologist or surgeon ever see you unless it is for emergency care. So no radiation, no prostectemy, etc.

I have sometimes seen vocational rehab programs take people that otherwise cannot get care and were able to work before the disease.