National Uninsured Resource Directory
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Established in 2008, the Patient Action Council is a forum comprised of like-minded pharmaceutical and biotechnology advocacy executives who NATIONAL seek to provide valuable tools to patients and improve healthcare in the United States. UNinsured RESOURCE DIRECTORY FIND THE MISSING 421 Butler Farm Road • Hampton, Virginia 23666 www.patientadvocate.org/resources PIECES ACKNOWLEDGEMENT The National Uninsured Resource Directory has been prepared by the Patient Advocate Foundation (PAF), a leading direct patient services organization in the country with a MISSION STATEMENT mission to eliminate obstacles for patients trying to access quality healthcare. PAF seeks to Patient Advocate Foundation (PAF) is a national non-profit organization that serves as an active liaison between the safeguard patients through effective mediation patient and their insurer, employer and/or creditors to resolve assuring access to care, maintenance of insurance, job retention and/or debt crisis matters relative employment and preservation of their financial to their diagnosis through professional case managers, stability relative to their diagnosis of life doctors and attorneys. PAF seeks to safeguard patients through effective mediation assuring access to care, threatening or debilitating diseases. maintenance of employment, and preservation of their financial stability. It is the intention of the Patient Action Council 1-800-532-5274 and the Patient Advocate Foundation that this publication be an educational tool to inform This brochure is available online at uninsured consumers of their options and to www.patientadvocate.org/resources provide tips on navigating the healthcare system. PRINCIPLE WRITING\AND EDITING: • Erin Moaratty PATIENT ACTION COUNCIL PAF, Chief of Mission Delivery • Pat Jolley, R.N., B.S. COMMITTEE PAF, Clinical Director of Research and Reporting I Amgen Oncology • Courtney Jones PAF, Director of Contract Vendor Services I Celgene Corporation • Judith Storey I GlaxoSmithKline PAF, Case Management Headquarters Director I Lilly Oncology • Michelle Smith I Novartis Oncology PAF, Case Manager I Patient Advocate Foundation • Kelly Alvord I Pfizer Inc PAF, Public Relations Coordinator I Sanofi U.S. CONTRIBUTING RESOURCES: • Rachel Allman PAF would like to acknowledge the 2011-2012 PAF, Case Manager Patient Action Council committee, PAF’s • Carolyn Andrews PAF, Senior Case Manager, Program Director Leadership Team representatives, and all who National Hispanic/Latino Outreach Program provided valuable information, support and African American Outreach Program guidance for this publication. • Wanda Febus PAF, Senior Case Manager, Program Director National Hispanic/Latino Outreach Program • Elaine Martinez PAF, Senior Case Manager • Tammy Neice PAF, Senior Clinical Case Manager • Tanya Walker PAF, Senior Clinical Case Manager TABLE OF CONTENTS How to Use This Guide ............................................ 2 SECTION 1 Who are the Uninsured? Insight on how individuals can find themselves without health coverage ............................ 3 SECTION 2 Accessing Healthcare While Uninsured Highlighting strategies for accessing medical care without insurance .................................. 5 SECTION 3 Financial Obstacles Tips for tackling the growing cost of care .................... 13 SECTION 4 Gaining Health Insurance & Your Options Assistance when navigating the plan options that are right for you ............................. 18 SECTION 5 Impacting your Healthcare with Non-Medical Means Suggestions on reducing your healthcare burden through everyday life ................................... 27 SECTION 6 Definitions & Insurance Related Terms A list of commonly used medical and healthcare terms ............................................ 29 SECTION 7 Patient Resources Contact information and a complete list of resources for the uninsured patient ....................... 33 SECTION 8 Quick Reference Quick reference cards summarizing key information for the uninsured .............................. 51 –1– HOW TO USE THIS GUIDE The National Uninsured Resource Directory is intende d to help uninsured individuals and families get connected with valuable resources. Patient Advocate Foundation (PAF) hopes that patients will ultimately feel more empowered when navigating the complex healthcare system and obtain the access to healthcare or health coverage they need. This print brochure outlines basic information, recommendations and helpful tips for uninsured consumers. Many patients find having these suggestions handy is helpful when speaking with their providers. We will divide the issues into four categories: accessing healthcare, the financial cost of treatment, future health insurance coverage options and how to impact care by non-medical methods. ad·vo·cate [n. ad-vuh-kit, ] 1 One that pleads the cause of another; One that defends or maintains a cause or proposal, or; One that supports or promotes the interests of another There are many different types of advocates, a friend or family member, nurses, healthcare professionals, social workers, educators, volunteers or a team made of up of these individuals. An advocate can help you better understand your diagnosis and the financial implications, support you through all aspects of care, educate you on treatment options, locate healthcare providers and maintain a broad awareness of your situation. Ideally, this allows more energy to be spent on your immediate medical needs and mental well being during treatment. We encourage all patients to be an advocate for themselves , and hope to empower you with the resources to do so in this brochure. For those with access to the internet, a more comprehensive up-to-date interactive tool is available at www.patientadvocate.org/resources . 1“advocate.” Merriam-Webster Online Dictionary. www.merriam-webster.com/ dictionary/advocate –2– SECTION 1: Who are the Uninsured? When a patient is diagnosed with an illness, he or she may quickly learn that they need insurance coverage to access adequate and timely care. For this publication, uninsured is defined as an individual that lacks any form of current health insurance coverage. Uninsured Americans can represent many diverse populations with a multitude of reasons for their lack of health coverage. It is helpful to recognize that uninsured patients come from all levels of society and may be: I Young adults (18-34) I Unemployed or have experienced a change in job status I Disabled I Those with early retirement at an age before eligible for Medicare I Self-employed business owners and household members I Recently separated military veterans I Low income earners or those that rely solely on supplemental income disbursements (SSDI, SSI, STD, LTD) I Workers in small firms/companies I Full time workers in companies that do not offer group plans, or the plan is cost prohibitive I College students who have yet to enter the workforce I People in families with part-time and temporary workers I Older adults that are not yet able to qualify for Medicare I Spouse or child of a person who’s employer does not offer family plan I People transitioning through various stages in life and may have a gap in insurance –3– Despite recent healthcare reform efforts, millions of Americans still remain uninsured. Patient Advocate Foundation wants you to know that you are not alone when dealing with your healthcare needs. PAF seeks to connect patients with national, state, local and regional resources that are dedicated to improving access to quality care and decreasing the financial burden of medical treatment. In this publication, we will be discussing some of the most common issues reported by patients served by Patient Advocate Foundation. –4– SECTION 2: Accessing Healthcare While Uninsured As an uninsured patient, there may be times that you find yourself having difficulty locating appropriate medical treatment. As you can imagine, health insurance coverage can make a difference in whether and when people get necessary medical care, where they access their care and how healthy they are able to live overall. People without insurance are more likely to delay or forgo preventive and routine medical care which may result in poorer health outcomes. In this section, we provide a list of tips for patients to gain and improve their access to care. THESE SUGGESTIONS MAY HELP YOU ACHIEVE SUCCESS FINDING CARE: I Utilize state and federal programs for free screening . Each state offers free annual pap smears and mammograms through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Some states also offer screening for various other types of cancer as well. If you’ve been screened prior to a diagnosis, some of these programs offer covered care. To inquire abou t free screening and diagnostic programs, contact your local Department of Health. I Apply for Medicaid programs if you meet the eligibility criteria in your state. In the event it is determined that you are eligible for regular Medicaid, you may be able to qualify for other programs available through your state such as food stamps and energy assistance. You can obtain information on these programs and how to apply by contacting your local Medicaid office. I Apply for county medical assistance programs if you are denied Medicaid. These programs are not available in every county; –5– however, when available, the program is a coordinated system for the low-income, uninsured residents of the county to access needed medical care on a sliding scale or at no cost.