General Question

jcs007's avatar

Any ideas on how I can get money for a medical procedure that I absolutely need but insurance doesn't cover?

Asked by jcs007 (1765points) August 30th, 2008

First of all, I want to say this: I hate health insurance companies. How the hell can you cover breast implants but not sleep studies?

My issue is that I have sleep apnea, but my insurance doesn’t cover the procedures I need to get done. The place doing the sleep study was kind enough to lower the price so that my family could kinda afford it. Problem is, $1000 isn’t exactly “affordable” given the circumstances. I was thinking of taking out a loan, but I really don’t want to pay interest. It would take too long to get an answer from Medicaid. I just started the semester, and this whole sleep issue is really affecting my grades. It’s just so hard to stay awake in class and while I’m doing my homework…

Anyone have any other ideas? I really have to get this done soon. Otherwise I may not survive the semester…

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14 Answers

poofandmook's avatar

are they willing to do a payment plan?

stratman37's avatar

Aw, man I feel for ya. My insurance covered mine, and yeah, it was expensive! Have you tried asking churches for help? Many local congregations have a student outreach that your expense may fall under. I hope you get it paid for, I know what you’re goin’ thru.

JackAdams's avatar

I have sleep apnea myself, and I would stop breathing in the middle of the night, but would always wake up, gasping for air.

I finally solved the problem forever, without any surgery.

I now sleep only my side, with a pillow under my head and another one between my legs.

I only had the apnea when I was on my back, and I haven’t slept on my back in over 30 years.

Perhaps that might work for you, as it did for me.

If I had an extra $1,000 to spare, I would be happy to send it to you for your procedure, and you would never have to pay it back.

August 31, 2008, 2:37 AM EDT

poofandmook's avatar

This seems silly… but I knew someone who set up a bare-bones free website and a paypal account and sent it to everyone he knew. A bunch of people chipped in a buck or two here and there, and within a few weeks, he had the money he needed.

windex's avatar

1000 or 10,000?

If you typed correctly, then I PROMISE YOU if you setup something on http://www.chipin.com/ we (your fellow flutherers) will raise the money for you.(unless this is somehow against the T&C then nm)

cak's avatar

Sometimes are are local agencies that will help out. It may take a little research, but if you know what hospital they would perform the procedure at, sometimes, especially county hospitals will have people they can put you in touch with – some will give you part of the money or all. Also, ask if the hospital will set up a payment plan, some will do that for you and when the money is saved, they will perform the surgery.

Let me know if you set up a fund. My husband had the surgery and it’s changed his life. He’s well rested and can breathe so much better. I know how miserable he was, I hate to see other people suffering!

jrpowell's avatar

I would happily donate 20$ to this. If a mechanism was in place to do so.

yannick's avatar

@ jp: As would I.

jcs007: Why don’t you set up an account with what windex suggested. I’m sure plenty of flutherers would be more than happy to chip in!

kevbo's avatar

Fundable.com is another fundraising Web site.

Will your insurance cover the CPAP machine? If not, you may want to consider just getting your hands on a machine (also expensive). The purpose of the sleep study is to verify the apnea (duh) and determine the amount of air pressure you need to keep your airway open. So, half the night is spent gradually ratcheting up your air pressure until you breathe normally. You might consider taking that step into your own hands if you feel confident that you can figure it out. It’s not rocket science, and the worst you’ll get is another night of apnea. Mine’s set on about 14 psi, by the way.

Definitely try sleeping on your side as suggested above. That helps in a lot of cases including a skinny friend of mine who isn’t able to tolerate a mask. She sewed a tight t-shirt with a pocket on the back big enough for a giant styrofoam
ball. Also, don’t drink alcohol in the evening before bed.

One other bit of advice, protect yor CPAP. Mine was stolen from my car, probably because some meth head thought it was a
laptop.

Good luck and let us know where to donate.

kevbo's avatar

Also, call your state’s dept of insurance to determine whether your insurance co has to cover it. I think most states require insurers to cover medically necessary treatment. Raise some hell and use the company’s and the state’s Appeals and Grievances processes.

Megan64's avatar

Sometimes if you talk to the Dr. and tell him/her that you don’t have insurance, s/he will charge you a lower rate for the procedure. Costs are inflated because the system expects the insurance companies to pay for services, not people. It worked for me. I got deep discounts on several Dr.‘s appointments just by asking. I realize a procedure is different than an appointment, but it doesn’t hurt to ask.

srmorgan's avatar

It seems odd to me that this would not be covered.
Sleep apnea can be a life-threatening condition and testing to determine it’s existence is not frivolous and is usually medically necessary.
Most insurance companies have an appeal procedure in place and you should check your policy or handbook or guide to see what is available.

Companies have strange criteria for what they may or may not cover. In my case when I was diagnosed with sleep apnea, the testing was covered (I had two done) but the CPAP was only covered as an on-going rental and the company would not purchase the devise for me. Over time they paid out what had to be more than the cost of the equipment but companies are funny in how they conduct their business.

SRM

marinelife's avatar

If you are able to stay awake, please write to both Presidential candidates about your dilemma. We need improved health care in this country.

I am sorry for your difficulty, and I hope that you are able to get treatment. Would the college have a clinic that could help? The treatment for apnea does not require a specialist’s expertise usually.

jcs007's avatar

@poof and cak: As soon as I get in contact with them, I’ll beg, cheat, steal, bribe (well maybe the first one, since I do not approve of cheating, stealing, or bribing) to get a monthly payment system. If this works, then this will probably be the fastest way for me to get the test and then the procedure. I’m keeping my fingers crossed for this one. Hopefully, they’ll consider my status as a student…

@strat: sorry to hear that insurance companies still charged you an arm and a leg, even though they covered your procedure. Asking my church is a feasible option. The Pastor there actually visited me the last time I was in the hospital, so he has an idea of my medical situations. This is definitely going on my list.

@Jack: After my first test, I was told that sleeping on my side reduced my apnea, but even then, I was still not getting good sleep. It’s good to know that you were able to fix your condition by figuring out a way to stay on your side. Hopefully, the next president can revise America’s health care. Then, we both wouldn’t have to worry about fixing any more sleep problems. By the way, thanks for the offer! When I write to each candidate about health care, as Marina suggested, I’ll make sure to mention my fellow Flutherite.

@megan: The doctor that referred me to the testing center actually told us to talk to the big boss over there. The $1000 price tag is actually as low as they can go (from $2400). The doctor also said that once the test was done, he’d figure something out to get the procedure done as well. So, hopefully I’ll get the discounts when I need them.

@srmorgan: That’s what I thought! Seriously, on the list of things not covered, they had something to the effect of: “Sleep studies and anything related.” (I forgot the exact wording). But on the list of things covered, they had “implants.” Now, when I wrote the question, I was kinda mad at my insurance for covering “implants”, but I’m not positive that they’d cover breast implants. But still! Like you pointed out, sleep apnea can be a life-threatening condition. While I’m sure implants are needed for life-threatening conditions as well, they should at least cover all the stuff that can kill me…

@Marina: as good as my university is when it comes to medical issues, they don’t offer anything to help sleep issues. I’m going to take up your suggestion of writing to both Presidential candidates. In the past, I’ve actually had responses from Dick Durbin and Barack Obama. Hopefully, I can get a response from Obama and McCain as well.

@everyone-who-offered-to-contribute: I was touched when my fellow Flutherites offered to donate to me for my medical bills. You guys are living proof that there are some really good people out there. I would feel guilty getting money from everyone here, since I know my parents would be able to afford it eventually. It’s just that time is against me right now. Plus, I’m sure that any money would be greatly appreciated for the relief efforts in the South. I’m just one person. I’ll get by for now. Perhaps my fellow Flutherers can focus their kind efforts on everyone affected by the hurricane. =) I don’t have any relatives in Gustav’s path, but I’m sure that the people that are in the way have much bigger problems than me getting kicked out of college since I can’t focus and sleep

There are some really good ideas here, some of which I will try as soon as possible. Thanks, again, everyone! It’s people like you that make me love Fluther! =)

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