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question about medical coverage for poor people

This so dumb, but I can't stop thinking about it.

This older lady was standing at the entrance to the Metro this morning holding a HUGE hand written sign saying her adult son had diabetes and he was "DYING" because he couldn't afford the insulin and they needed money to help pay for his insulin. 

My initial take on this is that of course this is a scam and of course, even if he/they  doesn't have money for the meds, if he has something treatable like diabetes, of course he can get the insulin through some type of program - probably some kind of medicaid/medicare program, etc. - it might not be as fast as he'd like and I'm sure there are all kinds of bureaucratic hooops to jump through, but of course people can get prescriptions filled for standard everyday things like insulin, even if they go into to some kind of debt for it.  Right?

Its like the homeless guys who go around saying they're hungry and begging for money and say they haven't eaten for days, when I see them lined up for the soup kitchen truck every night.  (I'm not saying its a tasty meal, but you're not starving either).

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Re: question about medical coverage for poor people

  • Yes, he probably can get insulin for diabetes for free/cheap. He can also probably go to a clinic (I am assuming this is in DC) to see a Dr. The clinics have long waits. Also, if they are truly poor, couldn't they go on medicare/caid?

    I would have to agree with you.

    BTW, her son is dying, but then again so is everyone else on this planet Wink

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  • imagemadladybride:

    Yes, he probably can get insulin for diabetes for free/cheap. He can also probably go to a clinic (I am assuming this is in DC) to see a Dr. The clinics have long waits. Also, if they are truly poor, couldn't they go on medicare/caid?

    I would have to agree with you.

    BTW, her son is dying, but then again so is everyone else on this planet Wink

    My thoughts completely.  There are charity clinics and lots of ways to get coverage if you are absolutely that poor.  I find that the middle class who do not have good health insurance actually end up paying more for their necessary health care.   Just my experience in what I've seen in my field.

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  • Not Necessarily...  Mediciad has a specific exclusion for childless adults between the ages of 19-64.  So if the guy doesn't have a kid he likely cannot get Medicaid no matter how sick he is.  He also would NOT be eligible for coverage under EMTALA (Emergency Medical Treatment and Active Labor Act) because that only covers someone in an emergency room with a life threatening emergency.  So if he was a step from death they could give him dyalisis, but they could not continue to give him on-going treatment once the life threatening emergency has ended.

    This is one of the things that is changed under "ObamaCare." Medicaid is expanded to include childless adults who make less than 133% of the poverty level.  In 2011 the HHS Federal Poverty Level (FPL) for 1 person is $10,890.  So if "ObamaCare" was effective today, that guiy would have to make less than $14,483 to be eligible. 

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  • I'm assuming she's referring to an adult son, so there are all sorts of ins and outs... it would depend on whether he is a resident of MD, DC, or VA (Medicaid is state-operated), his income/employment/assets, whether he's a citizen, whether he has kids, etc.  You have to provide lots of documentation to prove that you're financially eligible for Medicaid, and if he is homeless, he probably doesn't have easy access to that documentation.  You also have to prove residency- again, homeless, no proof of address, no residency.  There are federally qualified health centers that provide care at reduced rates, also safety net clinics, but it could be challenging to find one if you don't have easy access to the internet.  I don't think that an ER would give a patient a long-term supply of insulin.  So if he really is destitute and/or homeless, there are lots of potential barriers.
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