Medi-Cal Programs contain information that describes various programs, including overviews, user guides, policies, and billing instructions. BCCTP Update. CHDP Provider Manuals and Bulletins. EHR Incentive Program. EWC Manuals, Forms and Worksheets. Managed Care. Presumptive Eligibility (PE) Programs. While six-figure debt might be the norm for medical students, if you apply to affordable medical schools, it can make a big difference in limiting your student loan debt. And that gives you a huge head start in repaying medical school debt. Medi-Cal benefits offers free or low-cost medical and dental services to eligible residents. It is is California’s Medicaid program. The County Medical Services Program (CMSP) is a county-funded program that provides temporary health care coverage for eligible residents.
If you’re facing medical bills that you can’t afford to pay, you’re not alone. Sixty percent of bankruptcies in the U.S. are filed at least in part due to high medical bills. With the rising costs of health care, a hospital stay can break even the most solid of budgets. The costs of a long-term, chronic illness can be even worse.
Even with good insurance coverage, your out-of-pocket costs can be huge. If you’re uninsured or underinsured, medical bills may seem like a tidal wave in which you’re drowning.
Help is available, however, from a wide variety of resources, depending on your particular circumstances:
General Assistance
Government benefits
Benefits.gov will help you find government benefits to which you may be entitled. A short online questionnaire will help direct you toward benefits you can apply for, including those that help with health care and child care. You can also check a box at the bottom of the list to find out what benefits you could qualify for in every category.
You’ll need to have information about your income and any benefits you receive ready. The form goes through several pages, but you can click “View Benefits Results” at any time. The more information you put in, however, the more accurate and extensive the programs suggested will be for your particular situation.
The United Way
The United Way has a broad reach into each community and can provide you with information about medical assistance in your particular area. Dial the three-digit number 211 to talk to a referral specialist in your community, or go to 221.org. They can give you information on anything from drug and alcohol treatment to community clinics. The referral specialists can also help connect you to health services and senior services in your area.
Free clinics
Many communities have free clinics that can help with medical or dental needs. Search for a clinic near your zip code at the National Association of Free & Charitable Clinics’ website. Each has detailed information, including directions to clinics and the services offered by each one. The services provided vary with each clinic, but generally can include medical services and treatment, including lab work and access to free or greatly discounted prescription drugs. Vision care, dental care, and mental health services are also sometimes included.
State-sponsored programs
Each state has programs to help with financial assistance for medical care, health insurance, prescription assistance, medical supplies and equipment, respite care, disease screening, and more. Search by state at NeedyMeds.org for details about what’s available where you live. For example, Alabama has 21 programs offering help with everything from HIV/AIDS to breast cancer.
Prenatal Care
Department of Health and Human Services programs
The U.S. Department of Health and Human Services can refer you to free or low-cost services for pregnant women and their babies in your community. Call 1-800-311-BABY (1-800-311-2229). For information in Spanish, call 1-800-504-7081. The agency can refer you to your state or community’s Healthy Start program to help improve your health before, during, and after pregnancy. Healthy Start also helps families care for babies through their first two years. They can refer you to newborn health screenings and a home visit program to help ensure a safe, healthy environment for you and your baby.
Health care centers
The U.S. Department of Health and Human Services also has health care centers that provide a wide variety of services, including complete care when you’re pregnant. They’re located in most cities and rural areas. You pay only what you can afford. You can also receive checkups, treatment for illnesses, immunizations and checkups for your children, dental care for your family, prescription drugs, and mental health and substance abuse care if needed.
Planned Parenthood
Planned Parenthood has over 700 health centers located across the country. The organization helps provide pregnancy testing and general health care to women (and to men as well). Check online to find the closest Planned Parenthood clinic in your area. The list specifies the services offered, and you can check to see when appointments are available and make one online.
Medicaid
Medicaid covers other conditions as well, but it also helps finance 40 percent of all births in the U.S. Coverage for pregnant women includes prenatal care through pregnancy, labor, delivery, and for 60 days after you deliver. Medicaid is administered by individual states, so income levels can vary. Some states have also loosened income eligibility for pregnant women, especially if your health care expenses are sufficiently high. Babies born to pregnant women who are receiving Medicaid are automatically eligible to receive Medicaid until their first birthday. Citizenship documentation is not required.
Health insurance
The Affordable Care Act (“Obamacare”)
The Affordable Care Act (“Obamacare”) lets your enroll in private insurance through an online marketplace. Plans vary according to cost and what’s covered. Subsidies are offered to help pay for the insurance. This act has specific enrollment periods. After Feb. 15, 2015, you can enroll in one of these plans only if you have a life event such as getting married or having or adopting a child. You can also enroll at any time if you’ve lost other health care due to reasons including job loss and divorce. Otherwise, you’ll have to wait until Oct. 1, 2015 for the next open enrollment program to begin.
Medicaid
Prenatal benefits are discussed above, but Medicaid also provides health coverage to millions of other Americans, including eligible low-income or elderly adults, children, and people with disabilities. It’s funded by the federal and state governments, but administered by the states. You can work and still qualify for Medicaid. Eligibility is based on your income and household size, and requirements vary from state to state. If you qualify, there’s no specific enrollment period – you can enroll at any time. Find out if you qualify, and start an application.
Children’s Health Insurance Program (CHIP)
If you have children, you may be able to get health care coverage for them through the Children’s Health Insurance Program (CHIP). Over 8.1 million children are enrolled in the program, which is administered by individual states. Coverage varies from state to state, but all cover check-ups, immunizations, hospitalizations, dental care, lab services, and x-rays.
Click on a map on the federal government’s Medicaid site to find out the particular income requirements of your state’s program and for more information about how to sign up.
Medicare
Older adults have specific health care programs, such as Medicare, that help cover their medical needs. Depending on your income and resource levels, you may also qualify for help paying for prescription drugs. They also may qualify for additional help through programs such as PACE (Program of All-inclusive Care for the Elderly). This Medicare/Medicaid program is for people age 55 and over and covers services such as adult day primary care, home care, and respite care. You can also get help paying for Medicare Parts A and B (hospital insurance and medical insurance) in some instances and receive assistance through Extra Help to pay for prescription drugs through Medicare.
Special needs health care
Children and Youth with Special Health Care Needs (CYSHCN)
If you have a child with disabilities, the costs for his or her treatment can be daunting. Even if you are uninsured or underinsured and don’t qualify for Medicaid, you may be able to get health care assistance through Children and Youth with Special Health Care Needs (CYSHCN). Your child must have special needs in order to qualify. These needs must be serious, long-lasting disabilities including physical, behavioral, or emotional issues. Eligibility varies according to your income, your child’s age and health condition, and the state in which you live. Services include assistive technology, early intervention and screening for health risks, and family support. Visit FamilyVoices.org and click on the state map for more information about your state’s particular programs. You can also contact your state’s Department of Health & Human Services for more information. The program’s name can vary from state to state.
Dental care
Donated Dental Services
The Donated Dental Services (DDS) program provides free dental treatment to people who are elderly, disabled, or medically fragile. They have more than 15,000 dentists who volunteer across the country. Check here to see what help is available in your state. Participants usually pay nothing for their care, but if you can afford it, you may be asked to pay a small amount, especially if you require lab services.
Prescription drug assistance
Pharmaceutical companies
Skipping needed medication can lead to even more serious health problems. Many pharmaceutical companies have programs to provide medication for free or at a reduced cost. Research what help is available for your specific medications at RXAssist.org or the Partnership for Prescription Assistance. Your doctor may have to fill out or send in forms on your behalf. Each program has its own requirements, but generally, you’ll need to have no prescription insurance coverage, meet income guidelines, and be a U.S. citizen or legal resident.
Tips for saving on prescription drugs
Your doctor’s office may have samples of medications from pharmaceutical companies. They may not think to ask if you need samples, but if you ask, they’re more than happy to check to see what you have.
If you have prescription drug insurance coverage, get a copy of your company’s formulary and take it with you to your doctor’s visit. This list of preferred medications will help you save, since insurers charge a good bit more for drugs that aren’t listed on the formulary. Ask your doctor if one of the preferred drugs will work for your condition.
Help for veterans
Veterans can receive assistance through the U.S. Department of Veterans Affairs. Nearly 9 million veterans are served each year at over 1,700 sites of care. Help is available for everything from smoking cessation to prosthetic devices to weight management. Mental health services are also offered, as are programs to help people who serve as caregivers for veterans.
Medical equipment and supplies
If you need medical equipment or supplies, organizations are available to help through permanent donations or loans. Check GoodHealthwill or Rehab Equipment Exchange to look to see what’s available in your state. Most are free, but some do charge a fee. Pediatric and adult equipment and supplies are available. Some of the items available include wheelchairs, hospital beds, and slings.
Hospital care
Free or discounted care programs at not-for-profit hospitals
There are nearly 3,000 not-for-profit hospitals in the U.S., so chances are good there’s one in your community. These hospitals pay no taxes and in return are expected to offer a community benefit, including free or discounted care for patients who can’t afford to pay. Many hospitals, however, fail to tell patients about these programs. If you know in advance that you face a hospital stay, ask if the hospitals in your area are not-for-profit, and talk with them about the programs they offer. Even if your only option is a for-profit hospital, many of these offer charity care or financial assistance policies. Ask about these programs and apply for any you may qualify for.
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Help for specific illnesses
CancerCare
CancerCare provides assistance to help eligible families pay for cancer-related costs. You need to meet financial guideline limits and have a confirmed cancer diagnosis for which you’re in active treatment. CancerCare helps with transportation costs, home care, medical equipment, medication costs, and child care. There are different requirements and help offered according to the type of cancer you have. Oncology social workers can also help refer you to other financial assistance resources. Call 1-800-813-HOPE (4673).
The Assistance Fund
The Assistance Fund is an organization that helps individuals who need help paying for specialty prescription medication. It has two programs – one for help with copays, and one for help paying for monthly insurance premiums. You’ll need to meet financial criteria based on income and household size and you’ll also need to have insurance. You can get help from both programs if you qualify for both, as long as funds are available.
Good Days from CDF
Good Days from CDF helps defray the costs of specific medications used to treat a wide variety of illnesses, including rheumatoid arthritis, Crohn’s disease, and multiple sclerosis. Good Days from CDF offers financial help for over 30 illnesses. You need to have health insurance to receive assistance from this program, and you also have to meet income requirements. In addition, you need to have been prescribed a medication covered by the organization.
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Leukemia & Lymphoma Society
The Leukemia & Lymphoma Society offers assistance with managing health care claims and filing appeals if needed. It has a co-pay assistance program to help pay for insurance co-pays and premiums, as well as prescription drug costs. Applicants must qualify financially and medically in order to receive help. Specific assistance limits vary by type of blood cancer.
National Organization for Rare Disorders
The National Organization for Rare Disorders (NORD) offers financial help with insurance premiums and copays, diagnostic testing expenses, and travel to disease specialists not covered by insurance. It also works with other organizations and companies to provide travel and lodging assistance to participants enrolled in certain rare disease clinical trials. Specific diseases and medications are covered by NORD.
Caring Voice Coalition
Caring Voice Coalition provides financial help for people with conditions that are rare, chronic, or life-threatening, such as severe pain and Huntington’s Disease. It aims to help patients of so-called “orphan diseases” that may not receive the attention and resources that other more well-known diseases have. Patients receive monetary grants to help pay for prescription co-pays and health insurance.
HealthWell Foundation
HealthWell Foundation helps patients with chronic illnesses pay for prescription drug co-pays, deductibles, and health insurance premiums. A variety of diseases, from gout to melanoma, are covered. If your condition currently doesn’t have a fund to cover it, keep checking back, because new funds are added throughout the year. To apply, you must have some type of health insurance to cover part of your treatment. You can apply online or by calling 1-800-675-8416.
Patient Access Network Foundation (PAN)
PAN will help pay for co-payment assistance for a wide variety of medications if you meet income requirements and also have health insurance. These are generally high-cost medications. You have to reside and receive treatment in the U.S., but you don’t have to be a U.S. citizen. If approved, you’ll receive a pharmacy benefits card to use to purchase your medication.
Patient Advocate Foundation
The Patient Advocate Foundation offers help for patients with diseases such as osteoporosis, ovarian cancer, and hepatitis B and C. The organization helps with mediation and negotiation related to medical debt issues, as well as copay assistance. You’ll need to provide data such as your insurance information and policy number, Social Security number, and household income (not just yours).
Eye care
Sight for Students
Sight for Students provides free vision exams and glasses to low-income, uninsured children age 18 and younger. It helps more than 50,000 children age 18 and younger each year. Gift certificates are issued to providers to pay for your glasses. Check the list to see if there’s a provider in your area. The child must not be enrolled in Medicaid or have other vision insurance, and the child or parent must be a U.S. citizen or legal immigrant with a Social Security number.
EyeCare America
EyeCare America is offered through the American Academy of Ophthalmology. Volunteers provide eye care to people who may be at risk for glaucoma, senior citizens, children, and people with diabetes. Complete an online questionnaire that includes information such as your citizenship, medical insurance, and eye health-related questions. If you qualify, you’ll see a confirmation number on your screen. Print it out or write it down. Within a week, you’ll receive a letter with the name and phone number for a volunteer ophthalmologist who will have been notified that you’ll be calling.
Vision USA
Free Medical Programs In California Today
Vision USA optometrists provide free eye exams from optometrists in 39 states and the District of Columbia. To qualify, you must have no private or government insurance, including Medicare or Medicaid. You’ll also need to meet income requirements based on your income size and not have had an eye exam within the past 24 months. You cannot have received a doctor referral through the program in the past two years.
New Eyes for the Needy
New Eyes for the Needy buys eyeglasses for people in financial need. Applications need to be completed by the person applying for help as well as a social service agency. Include a copy of your recent eyeglass prescription. If you’re approved, New Eyes for the Needy will send you a voucher that you can take to a participating eyeglass provider. The voucher will pay for your eyeglasses – you won’t have to pay any additional money. The agency doesn’t pay for the exam, but you can contact them if you need help paying for an eye exam
Mission Cataract USA
Mission Cataract USA offers free cataract surgery to people of all ages who otherwise can’t afford to have the surgery. To qualify, you need to have cataracts that cause poor vision that’s uncorrectable with glasses and interferes with your daily activities. You must have no Medicare, Medicaid, or private health insurance, and no other means to pay. Check to see if a participating doctor or clinic is available in your state.
Hearing aids
Hearing Loss Association of America
The Hearing Loss Association of America has information about a wide variety of assistance programs in each state, as well as specific programs to benefit veterans and children. Information about getting assistance with telecommunications equipment for the hearing impaired is also included.
The HIKE Fund
The HIKE Fund helps provide children under the age of 20 with hearing and/or assistive listening devices who have a financial need. An application requires a letter from the family, as well as a copy of your last tax return and a pay stub, if applicable. You’ll also need a copy of your child’s audiogram. Include a copy of an itemized quote from a hearing aid or assistive listening device supplier.
Other ways to save
Crowdfunding
More people than ever are turning to crowdfunding sites like GoFundMe.com and GiveForward.com for help paying for their medical needs. Often it’s used for specific goals like cancer treatment or transplant surgery that’s not covered by insurance. Donations are collected online and then sent to you, with the crowdfunding site taking a small percentage.
Medical bill advocates
Medical bills are often complicated, indecipherable documents that can filled with incorrect charges. The problem is that most people who aren’t medical professionals can’t translate them well enough to tell if there are any errors. Medical bill advocates are individuals or companies who, for a fee, will go over your bill to make sure you’re not being overcharged. Some charge by the hour, and others take a percentage of what they’re able to save for you.
If you’d rather try looking at your bill on your own, ask for an itemized bill or EOB (Explanation of Benefits). Common errors include duplicate charges or procedures that were incorrectly listed.
Also make sure that if you’re insured, the charges match the amount that your insurance company has negotiated with the health care provider for. Sometimes doctors or hospitals will try to charge you the difference between their normal charges and what your insurer will pay, and you may not necessarily be responsible for the difference. Check with your insurance company for more details are their agreement with your healthcare provider.
California Medical Program Eligibility
Negotiate
Either before or after the fact, doctors, hospitals, and other healthcare providers may be willing to negotiate for a lower fee if you simply can’t afford the original amount. In fact, if your doctor will call the hospital on your behalf, you have some extra clout behind you. They’ll often work out a payment plan with you rather than turning your account over to a collection agency.
Shop around
It may seem strange to compare prices for health care, but there’s nothing wrong with doing so. If you’re facing surgery, for example, could it be done as safely in the doctor’s office or a surgical center, instead of a hospital, which is likely to be more expensive?
The Department of Health and Human Services has found huge gaps in what healthcare providers charge for the same procedure. One California facility, for example, charged 42 times what an Oklahoma provider bills for the exact same procedure. These differences in price can also vary widely within a small geographical region, the Department of Health and Human Services found. Ask about the charges for your procedure before you have it, and research online to find customary charges for what you’re having done.
FairHealthConsumer.org is a non-profit site that lets you look up customary charges for medical and dental procedures in all 50 states. If you have trouble navigating the site, you can call them at 1-855-566-5871.
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