Healthcare Tips for the Broke-Ass Masses

Everything about this photo is a lie

image from Huffpo

Being a New Yorker is a little tough, all the time. Whether it’s the train that just left or coming up with the perfect save to that horrible interview question…. on the elevator going down, there’s always some bitty truth to the adage about making it here.

But we do ok, in general. We can usually afford a third beer and there’s four D trains for every F that never comes. We do ok, unless Something Happens. And when Something Happens- some shitty twist of employment, housing, health, relationship- that’s when you pussy up or move to Seattle. Last year Something Happened to me, health-wise, uninsured-wise, and therefore SOL finances-wise. When a mystery ailment goes from the relatively affordable ‘hipster with back pain’ to ‘yearlong undiagnosed Lyme Disease’ (oops!) you get an unwanted lesson into the labyrinthine US healthcare system. And after morosely handing a Hefty bag of 2011 medical bills to a tax broker and her laughing out loud, one realizes there’s rules of thumbs to be imparted to fellow uninsured BrokeAsses who get sick.

1. There are good low-cost clinics.

You just have to find them, and advocate for your right to competent care.  Remember that, though most doctors and PA’s mean well, they’ve also seen 300 people before you and have 300 after.  Come early for your appointment, be clear with your symptoms, and don’t let anyone shovel antidepressants at you if things aren’t totally, immediately clear. A doctor needing you to leave quickly has occasional pharmaceutical benefits: who wouldn’t love dumping a ream of uppers, downers and sleep aid scrips on the Duane Reade pharmacy counter and going home with a Pfizer warehouse worth of ‘when I need it’ Baclofen? It happens. When a situation is tough to understand, overworked clinic staff sometimes have to Cliff’s Notes your problem and pull out the Rx pad. So write symptoms and timelines down and don’t be afraid to question. Just because you’re poor doesn’t mean you’re undeserving of time. For the billing/financial aid office, be ready with proof of income. Sharpen fake crying skills, just in case. Or cry for real, if the need arises (which it might). Whatever. A quiet but public sob in a waiting room is embarrassing, but cost/benefit analysis says pack the Kleenex if it means an earlier follow-up appointment  or an extension on your balance.

Some good places: Planned Parenthood, amazing, can’t say enough. Sliding scale is fair, with a compassionate and invested staff. Bellevue’s clinics can be cheap as shit for the uninsured, if you’re willing to wait- I’m talking ‘2 months for appointment, 4 hours till you’re seen’ kinda waits. Coney Island Hospital has affordable testing.

2. Keep your receipts.

Yes, that bill DOES say $881.00. Top o’ the mornin’, credit card application!

In NYS, if your out-of-pocket medical expenses exceed 7.5% of your income, the rest is deductible. There’s more math, but that’s why there’s H&R Block tax-estimate tools online. Point is, if you get sick and you spend money on anything- testing, appointments, procedures, prescriptions, even a foam roller from Target ($34.95)- hold onto the receipts. Make a spreadsheet as you go and divide expenses into categories for ease at tax time. Simply laugh at the total come March, because crying won’t pay your credit card minimum. SPEAKING of…

3. Pay your credit card minimum
That’s just good sense. And remember that certain institutions can be talked down when it comes to penalty interest. Except Chase. Chase is a real motherfucker.

4. Negotiate, dude
When you’re sick and broke, you got nothing but your dignity. But don’t bother with that, cause you also got rent. Call the lab’s billing/doctor’s accounting department and ask about financial aid. Get a payment plan. Don’t ignore bills, because that makes rheumatologists and your mailman mad. Grovel. Remember the crying? It works on the phone too! There’s always a chance your bloodwork can be brought down if you ask nicely. Times is tough, yo, and the women in Billing know that.

5. Ridiculous coupons, both laminated and not
You know those commercials you see for Rx discount cards? The ones advertised online that just need to be printed out and seem too good to be true? Well, they’re real. And they are fucking awesome. For the uninsured, and maybe soon for the blissfully insured (lookin’ at you Arizona, ya nutty bitch), birth control can be expensive and hard to access. With a discount card, you can get 20% off Nuvaring. Rite Aid and Duane Reade have ‘flex rewards cards’, through which you can get daily meds like generic Synthroid for $8.99.

Check out sites like http://freedrugcard.us/. You might feel like an idiot handing a flimsy print-out to a pharmacist, but it’s worth it when you could save up to 60% on a Z-pack for surprise strep throat.

6. Zinc
Seriously. Take your zinc.  Christoph, my buddy from Munich, introduced me to it during Oktoberfest.  Feverish after three days of no sleep and an IV of red meat and Augustiner Bräu, we sprang back to life like Tinkerbell (It doesn’t do shit-all for Lyme Disease, but it might keep you out of waiting rooms)!

And by the way, I’m getting audited for that tax return! Apparently the IRS would rather fuck around with average folk and their Hefty Bag of bills than waste time with trivialities like GOP lobbyists with suspicious offshore accounts.  Obama. Buddy.  Please keep pushing for uninsured BrokeAsses like us.

Photo by Me