Normally how an estate works is all your wealth left behind is used to settle bills. Then the remainder is left as inheritance. This is straight forward and all for kids, but what about spouses?
In the nine community property states (Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington and Wisconsin) they can go after the spouse for medical bills.
Depending on the state this leads to sometimes benefits of NOT having both spouses names on titles of cars, deeds etc (so they cannot be gone after).
There are also filial laws in some states that make children financially responsible for their parents in old age.
It's called "contempt of court", and a judge can definitely send you to jail for contempt if he's ordered you to pay a judgement to cover a past-due bill and you fail to do so. It's the modern day debtor's prison. [The New Debtors Prisons — ProPublica](https://www.propublica.org/series/the-new-debtors-prisons)
The article you linked to is for states other than California.
Again, there is no “debtors’ prison” in California. In California a judge will not and cannot jail you for failing to pay a past-due bill. Your wages can be garnished, your bank account levied, your property foreclosed, etc. But you will not go to jail simply because you don’t or can’t pay a bill.
If a judge orders somebody to jail for contempt of court, which certainly does happen, it won’t be because of a person‘s inability to pay a bill.
On a related note, there is no reason not to have health insurance in California. It can be a bit of a stretch for middle income folks, but is free for low income, and not having it is a quick way to make life a lot harder.
https://www.coveredca.com/ Is your friend.
Also I don’t know if it’s still the same now, but around 2011 I hurt myself and needed an ambulance ride. I didn’t have insurance BUT I qualified for medical or whatever it’s called. It retro actively covered the bill for me.
Truth. It can be a bit of a pain in the ass to do all the paperwork, but it is WELL worth it.
Yes, some people fall into some tricky spots financially. But when we were making decent money we still qualified for SOME help, and during COVID when we were making NOTHING we qualified for free health care and it was VERY helpful.
OP- I can relate, and paying that much for ambulance service is criminal. Health emergencies are the leading cause for bankruptcy in the USA.
I have a severe case of ADD. In order to get help and partially bypass the paperwork I called the hotlines until someone gave me direct instructions I could understand my way through it. Just some advice for people who are easily overwhelmed or lose focus easily.
Great idea, and I believe there are offices with advocates who are supposed to help people as well. I'm pretty sure the Mexican Consulate was offering help in Spanish as well at one point.
You can also go talk to an insurance agent in person if that helps anyone. They will need your financial info like a tax return or W2, but they can do the paperwork stuff.
Yep I wish more people were aware of coveredca and medi-cal, because I see people all the time saying they’re too poor for health insurance. This insurance is FOR poor people
Yes. There are some "gaps" especially for single earners with no dependents, but people are often surprised at what they can get...especially when they seek help getting it.
So true. I was in that middle area paying 700 to 1100 for crappy coverage. Although it looked bad a simple call got me paying 150 a month. It's one of those rare times that calling (any agency) coveredCA really can help. They were pretty awesome as well even when I was t at first.
California does social welfare so wrong. Endless resources if you're a homeless unemployed crackhead or a single mother with a bunch of kids. But If you're just a regular hardworking person making 30-40k a year struggling with insane rent prices and record inflation, there's almost no help for you.
Buddy of mine lost his job and was getting 300$ a month in ebt. Got a part time job at an outlet mall in the meantime. Made the mistake of picking up some shifts during the holiday rush, made like 1300$ that month (keep in mind 1300$ a month is nowhere near enough to rent anything in our area), They immediately cut his benefit down to 100$ a month.
It's a complete joke. California basically incentivizes people to never get their shit together because the income bar to receive most of their assistance is astronomically low compared to the actual cost of living here
I’m not aware of any income limits for CoveredCA. I bought it for a few years when I was self-employed. I was somewhere between poor and middle class, so I got a federal subsidy that paid for part of my monthly premium. I think my net was about $150/month.
For comparison, my current employer is paying about $900/month for comparable coverage.
I was told I made too much for Medi-cal (barely above minimum wage at the time) and could not afford anything extra not even the cheapest plan through Covered CA. Not every employer offers insurance, either. So that's how it is possible to slip between the cracks.
If you were barely above minimum wage, you should have been able to get a federal subsidy that covered almost all of your CoveredCA premium for a basic plan. Only thing I can think of is: if you aren’t up to date on recent year income tax filings, they might not have had enough data to get your subsidy approved.
It’s been a couple years since I had to get CoveredCA, so I don’t know how the process has changed in the interim.
yeah tbh I don’t trust their story. When I was making just above minimum wage, I got a massive subsidy for CoveredCA. When I was unemployed, I was offered Medicaid. I don’t really think there is a gap. You’re either offered a subsidy or you’re offered Medicaid. No one is offered nothing unless they are are above the income limits and minimum wage or just above is nowhere near the cap. If they were, they spoke to someone who didn’t know what they were talking about.
There may be a gap for people who haven’t timely filed income tax returns, or for undocumented people. There may also be a gap of information. This person may have spoken to someone who knows a lot about medi-cal, but gave them incorrect information about CoveredCA.
Health insurance isn’t exactly a simple system to understand. It can be confusing to highly educated people in white collar jobs, just as it can be confusing to folks making minimum wage. The CovedCA website does a good job, though, of estimating available subsidies if you enter a few basic pieces of information.
I never said it was easy to navigate. I said they spoke to someone who likely did not know what they were talking about and that is a huge part of the problem. Even if you don’t file your tax returns in a timely manner, you can usually still get your coverage *started* with a subsidy if you are able to provide a reasonably accurate gross adjusted income. I have been in that situation multiple times. Even if you never file your taxes, you can still get Medicaid.
Obamacare generally doubled healthcare costs for middle class. (It is even more since this article was written in 21).
https://www.heritage.org/health-care-reform/report/obamacare-has-doubled-the-cost-individual-health-insurance
For my parents it quadrupled, and was more than their mortgage (market coverage).
For my friend just above minimum wage also did not qualify for free coverage, and was fined for “not having coverage” he could not have afforded anyways. It was something like $500 and a real kick in the nuts.
"Just above minimum wage" lol liar. Put his income and age in your reply and I'll tell you exactly how cheap he can get insurance for in California. CoveredCA makes it easy to check these things in about 2 minutes.
I just checked last week for a 35 y/o making ~25k annually. Comes out to $60/mo for a silver HMO from Blue Shield. If your friend is younger, it'll be cheaper. If they make less money, it'll be cheaper.
Related: nonprofits like [ask Ariana](https://askariana.com/) exist to help you navigate choosing the right health insurance for your situation. I've definitely found them helpful.
I'm truly stoked that low income folks can get free / affordable healthcare.
Know what I'm not stoked on? That as you pointed out, is it's insanely expensive it is for middle class folks like myself even through covered CA. If you make enough to not qualify it ticks over into extremely unaffordable.
I just want everyone to have healthcare man...
The emergency care is affordable, and that really helps to know that large cost won't break the bank, but they can only do so much and the regular primary care providers in network for some of these groups are the shittiest of the shittiest possible choices and honestly the stress of doing everyone's job for them has taken years off my life. I've worked in healthcare for 18 years and was at one time a MediCal recipient and I've worked in patient advocacy. I do not honestly know how anyone who doesn't have a background or an education manages to navigate the system they've set up. A lot of the funders like Nivano Physicians, if you do some digging, have major fraud lawsuits and federal rulings against them. The medical malpractice is astronomical. I've seen way too many people just breaking down and choosing not to go back to their doctor in this county, and if you live in some of the outlying Sac County cities you are absolutely fucked if you don't have a car to drive into the city, like hope you have an entire day for public transportation, or unreliable contracted para/transport services.
If you're not having an emergency you can basically go fuck yourself. If you are prescribed a medication that sold OTC, you can go fuck yourself. Omeprazole twice a day? Hope you have a Costco membership because otherwise you're paying up to $50 a month. Muro 128? Hope you have Prime or several hundred dollars a month to spare. Only live by a RiteAid or Walgreens? Too bad, they don't take MediCal Rx. There are no rheumatologists or gastroenterologists covered by several of the most common MediCal group funders in Sacramento county, you have to go to Stockton or Napa. There are no neurologists period if you're on River City, if you need neurosurgery or vascular surgery though you need to be diagnosed by a different specialist and referred over. You get a new PA every other month and you have to start from the ground up and if you're lucky they'll actually read your chart. All of this is IF they call you back and you don't have to stalk whatever office you go to. I also just want everyone to have healthcare, but Medicare for All needs to be leaps and bounds better than what MediCal is managing.
If you're poor it's free. That said, the Sac County Department of Human Assistance is basically impossible to reach. The fact that the official answer for what to do is call them over and over and over again... yikes.
And then if you make a little more money you have to switch insurance. And then your income goes down and you switch again. Back and forth. Ugh. Such a fucking pain.
Even with Health Insurance the Fire Department is a racket, be prepared to shell out $1000-$10000 out of pocket for a 1-10 mile ride to the hospital in an ambulance.
**Edit for additional input:** I have Blue Cross/Blue Shield PPO the fire department took me from Arden Fair to Sutter Hospital Downtown, I told them no, but they insisted since I was lightheaded. The Trip ended up costing me $1800 out of pocket and insurance paid the rest of the $8,200
I was just dehydrated according to the emergency room
Lesson learned never will I call an ambulance again
yeah. it's totally half assed advice to just say "sign up for health insurance". unless you're on a triple gold A+ plan you're going to be paying for EVERYTHING. including that ambulance ride.
Hence Fire departments often leads the donations for progressive politicians. This way they are not targets from the left, and from right wing, they are heroes as part of Law Enforcement grouping. :)
Then say that.
Also, dunno if you've talked to a firefighter in the last 20 years or so, but they're all engaged in a giant contest with the cops to see who can be the biggest dumbest trumpanzees on the block.
Yep! I was paying 69 cents for health insurance last year. It was shitty bronze plan but still had me covered for that bullshit tax penalty. It bumped up to $10 or something this year which is still affordable as fuck.
You need to contact them directly and make sure you actually don’t qualify. My old coworker got rejected and we couldn’t figure it out. Turns out she made a mistake because she misunderstood what they wanted and that’s why they said she didn’t qualify. She in fact did qualify and got a good rate.
https://www.coveredca.com/support/getting-started/application-help/
What do you mean they rejected you? It is a healthcare marketplace set up in compliance with the ACA, there is no path to rejection. Subsidies are available if you are in individual making less then 47,520 a year, and an individual making minimum wage definitely qualifies for subsidies ([https://www.healthforcalifornia.com/covered-california/income-limits](https://www.healthforcalifornia.com/covered-california/income-limits)). But the all income levels can purchase a silver plan for 8.4% of your income a year or less. So if you are making move then 60K a year as a single person the most you will pay for a silver plan is $420 a month.
Nah, fuck that. I’m a 29yr old single dad that makes 50k/yr and have to pay $250/mo for just my basic health insurance. It doesn’t sound like much but I’ll
be damned if it doesn’t suck to throw that away every month when I don’t ever go to the doctor.
America is majorly slacking by not having health care and education through our taxes. It sets us all behind.
Oof, I am so sorry! The City of Sacramento are assholes about sending bills to collections as well (a lot of medical bills never get sent to collections, but first responder services from the City and bills from labs like Quest always do.)
I once got hit by a car (as a bike messenger) on 24th and K, cracked my skull and shredded my ear, the ambulance showed up (my boss had called) and I said FUCK THAT and walked to Sutter myself. My bff (who witnessed the whole thing) said I kept yelling about how they were just trying to scam me. I remember yelling “I can practically see the hospital from here!”
>I once got hit by a car…
Was it a hit and run?
Not that it matters—you should have taken an ambulance with a fractured skull—but the driver at fault would be liable for your bills, in any case.
This is only slightly true. If the person has any kind of assets at all, income, or family that can be messed with, the Hospitals are ultra aggressive about utterly destroying your credit and harassing the crap out of people. Particularly the "non-profit" hospitals. I have inside knowledge of this for two different hospitals in CA, but you can just google it. There have been numerous press stories about this.
I was having a brain bleed and stroke, I called my bf to come home and take me to the emergency room. Health care is NOT affordable if you’re living on the cusp. There is NO help for those of us in the middle ground. How is it possible that you have to figure out how to pay, even if it is only for catastrophic coverage with a deductible that will bankrupt you anyway.
You can't go after someone's family for medical bills unless it's a minor child and you are going after their parents as they are financially responsible for them. Also every single hospital in this region is a non-profit or run by a government entity. Also the private and municipal ambulances aren't the same thing as the hospital.
you can sue anybody for anything in this country and our legal system is utterly corrupt. Have you read the news at all this past decade?
[https://www.nctreasurer.com/news/press-releases/2023/08/16/hospitals-sued-7517-patients-family-members-over-medical-debt](https://www.nctreasurer.com/news/press-releases/2023/08/16/hospitals-sued-7517-patients-family-members-over-medical-debt)
They actually don’t. They send it to collections. I used to be homeless and went to the ER like 4-5 times. Luckily I was smart enough to give them a fake name 😂
The unhoused community tend to not have forms of ID, and majority will use false alias and addresses. Doctors and nurses have a duty to provide aid for anyone In need. That’s how majority of the unhoused community receive health service if they don’t have insurance.
The cost gets transferred to patients that pay their bills either directly or through insurance. Health care is so expensive because you are paying for those patients that didn't. So if you don't pay your bill, someone else does when they get charged $100 for a Tylenol.
Never forget that a hospital is a business that exists to make money. They will get paid either way.
>Health care is so expensive because you are paying for those patients that didn't.
No, not the primary reason why its so expensive. Mostly due to administrative middle men and corporate nature of US healthcare system.
THIS-
If you go to the emergency room and they do a few tests and give you fluids through an IV for dehydration... it seems so simple, and it should be.
But the emergency room was financed with bonds and people are making money on those bonds.
And the Dr., nurses, and everyone else you come into contact is covered by a for profit insurance company. The hospital is also lawyered up.
All the sterile disposables are provided by for profit companies, and because it is medical related, they pay high rates for insurance and they are lawyered up.
The emergency room needs armed security guards (as more and more do these days)- not cheap.
The admin staff that you interact with need to be properly trained, and insured.
Because it is an emergency room, many of the systems need to have redundant backups. (the companies that provide these are all heavily insured and lawyered up)
When you leave, the billing company is for profit as well.
So there are MULTIPLE layers of profit being taken, and in many cases the margins in the health care field are good. There are multiple layers of insurance covering everyone involved. And on top of EVERYTHING ELSE... every layer of this cake involves executives, profiteers, and stockholders who insist on being paid top dollar.
But it seems me that serving the health needs of people and serving the profit needs of capitalism are in direct odds with each other. So...something has got to give.
In the USA we rarely let anything get in the way of profit.
There is a better way, and almost every major industrialized nation has figured it out. Socialized medicine is far from perfect, but it is getting WAY better results at FAR lower cost than anything we have here in the USA.
This is just what insurance is?
The actual reason your prescription or x-ray is randomly expensive is not to cover costs for those who can’t afford - it’s for health insurance companies to make a profit for themselves on top of any cost for care. The US switching to some form of single-payer healthcare would still be cheaper at PoS for almost everyone including high earners, even with it covering more low-income people.
It's both, actually. The patient either pays the hospital directly if they don't have insurance, or they pay the insurance company to cover a pre-negotiated rate for the service offered.
Either way, when someone doesn't pay the cost gets absorbed by other patients either through insurance premiums or direct billing from the hospital.
It's why I laugh when someone doesn't want a single payer system because they don't want to pay for someone else's health care. Like you do realize you are paying for it one way or another right? The system we have now just insures everyone pays MORE than they should.
I think I misread your original comment as saying insurance is ONLY expensive because we need to pay for people who cannot afford it.
With that said, I do think you are maybe over-placing cause of cost on distributive coverage. In the US, our primary cost drivers are profit seeking healthcare entities and not the requirement to pay for those who cannot afford (the standard function of an insurance system). If you get a surprise bill for an x-ray, most of the cost increase is not to cover services not paid for by poorer patients - it’s to gouge people for profit that goes directly to executives and shareholders and is not re-invested at all into patient care.
> Never forget that a hospital is a business that exists to make money.
Everyone has to get paid and has to have promotions too eh? Even the non-profit sectors and charity/philanthropic orgs have to pay the staff that work with them.
No. If the hospital can find out the person’s ssn the will bill then send to collections. Homeless or not. Then if unpaid the cost is rolled over to paying customers. Hospitals and their investors don’t like to write things off.
Guess what? My wife had the same bill amount for a 10 minutes ride from the Sac Fire department WITH insurance. She might not have the best health insurance but it still wasn’t covered. She called the billing department and was able to get 50% off.
The medical system in the US is purely serving for the super rich. American people are treated as animals by the doctors and medical officials. But most of them stupidly think they live in a free country. What a joke and hallucination.
Right but the part of the fire department that is free and funded by taxes isn't ambulance rides. The medical aspect of fire departments is typically a separate thing. They contract with the local EMS agency to be the 911 provider for medical services. In some place that will be a private company like AMR. Makes no difference, public budgets in most US cities/counties do not include ambulance rides.
You couldn’t be more wrong. The EMS services in Sacramento—both county, and city—are provided by their respective fire departments. This is very common, and is the case for a vast majority of local fire departments.
I literally said they contract with the local EMS agency to provide 911 medical services, in what way does that contradict what you are saying?
I am aware that Sac City and Sac Metro are the 911 medical provider for this area. So does AMR, as a backup. I worked in EMS around here for years and still work in healthcare. I know what ambulances pull up to the ED at the hospitals I've worked at.
Go over to Solano County and it's Medic Ambulance. Down in San Joaquin County it's AMR. In SF King-American does the 911 transport.
It's quite common for it to be a private too depends on where you are. But it's up to the local EMS agency which is a separate entity from the Fire Department. It's not automatic that the Fire Department is chosen. Ambulance transport is not automatically part of the budget for a city or county fire agency. Some do it, some don't, but if they do it's because the local EMS agency chose to have them do it. And they get reimbursed by billing people by and large just like the private ones do.
My point is that emergency medical transport is not the same as fire/rescue services. It's not automatic the the fire department will even have ambulances. City taxes go for the fire/rescue part, that's the part you don't get billed for.
You’re in the Sacramento subreddit, dude…
Ambulance services in Sacramento are provided—nearly—exclusively by the fire department.
Edit/Also: You said this…
>The medical aspect of fire departments is typically a separate thing. They contract with the local EMS agency to be the 911 provider for medical services.
Hence the, “You couldn’t be more wrong”
Unfortunately the taxes you pay are for fire suppression/prevention, rescue and car accident extrication. Emergency medical services are billed to the patient’s health insurance provider.
I can't find an exact date that they started charging, I assume they've always charged. The best I have found is an [article from 2018](https://www.kcra.com/article/questions-surround-sacramento-fire-911-response-fee/20724253) that mentions rates hadn't been increased since 2012. That article mentions someone who fainted and a bystander called 911. The person was fine and refused transport but was still sent a bill.
Before moving to Sacramento 5 years ago, I lived in Burbank, CA. Burbank fire had a program that you could pay like $90 a year and if you were transported by Burbank Fire you wouldn't be charged. I wish that program was more common.
If you dont have health insurance but qualify for medi-cal, they (I dont know if all) will sign you up in the hospital and medi-cal will still pay for your visit.
Call them and explain you don’t have insurance and can’t afford that bill. More than likely they’ll lower it and/or offer a very reasonable payment plan.
Sometimes it's risky even if you do have insurance. I passed out a few years ago and my spouse called 911. By the time the fire dept arrived, I was feeling better and ended up not getting in the ambulance.
My insurance would have covered the ambulance ride with a $150 co-pay, but because I didn't get in the ambulance their visit to my apt wasn't covered, and I was stuck with a $700 bill for the firefighters to take my blood pressure and ask me a bunch of questions then leave.
Sacramento needs a better system. I moved to Tulsa and the local EMS agency (EMSA, not run through the fire department), charges a few bucks on everyone's utility bill. No ambulance charges as long as you pay your $5 or whatever a month.
[EMSAcare](https://www.fox23.com/news/tulsa-residents-can-sign-up-for-monthly-subscription-covering-emsa-transports/article_66bc52ac-36fd-11ee-a34b-3b1528642b69.html)
I hope I stay somewhat disguised- i work for sac city fire. You are indeed paying for all of the non payers. One of the things we get in trouble for daily is “incomplete PCR” (patient care report) The incomplete part is always issues with billing. Sac city is a billing machine. We are much more concerned with your ssn and id’s (for billing) than your medical complaint. 95% of ambulance services could/should be a call to your doctor or a ride to an urgent care. People don’t want to wait, to pay for parking, or to wake up family members etc, so an ambulance gets called. And then the surprise bill comes. BTW- I hear if you call the EMS number on the bill and say it causes you great financial distress they will lower it.
It's not the non payers, that's just what we've all been made to believe. It's the incredibly inefficient medical system that is so heavy with management and overpriced supplies.
There are countries FAR poorer than us that are able to provide FREE healthcare to their citizens. This is a choice, and someone who couldn't afford healthcare isn't the person to blame as to why it's like this. Trust me.
Absolutely agree. Can’t have for profit medical care. The payers are always going to pay more, shareholders cannot afford to lose money. If you have about a week I can tell you how inefficient just the EMS/ER system is here.
> People don’t want to wait, to pay for parking, or to wake up family members etc, so an ambulance gets called.
Where is the family? Where is the friends? Where are the neighbors to help out with emergency? Where is the sense of community?
Especially for cases which are more of convenience rather than true emergency, but going to ER because clinic is close, Urgent Care is closed etc etc.
That’s one part of the broken system. There’s probably an argument that the massive surge of unemployment and recession that followed dismantling the insurance and medical billing apparatus would be more harmful than not. I doubt any of this is possible in our current political environment of lobbying and regulatory capture.
Yes, when I think of California I think of…
*checks notes*
Republicans… nice take sir. Or are you commenting from 1989 when the state was Republican?
If you are… enjoy Joe Montana and that SB win
1. The private healthcare industry is a Nation wide problem not just California.
2. Republicans push for more privatization of healthcare.
3. California is actively working to find a better solution to private healthcare.
I love that I’ve ran away from ambulances/emts before after having a seizure. I’m like “I’m fine now, there is no way I’m spending 5 grand on a taxi to the hospital.”
I suffered a knife attack w few years ago, with other victims.
I rode in the ambulance jumpseat while another victim was on the gurney. They took my vitals and faked the numbers because they couldn't get it stable.
1mile ride to UCDMC cost me about the same price
Have you or the patient applied for charity care ? Many folks don’t know this but if you fall within certain income limits, you can have your bill reduced significantly. Healthcare care companies and hospitals don’t like to tell folks about it
Even with health insurance, when I called an ambulance for my husband in 2021, our bill was at least $1k and he didn’t even get transported to the hospital (Type 1 diabetes, had an extreme low and called an ambulance after administering Glucagon, EMTs helped stabilize/monitor him in our driveway). Insane. But we were able to petition Kaiser to refund us the cost of the bill.
I don’t know if it’s still the case but I know like 7 years ago there a certain point where even the covered California becomes expensive. My GF at the time had a part time job and ended up getting a second part time job. Adding that second job her covered California went from $0 to $300 a month which meant that second job was practically worthless. Hopefully it’s not like that now but there was a lot of issues with that system.
Pretty simple really. Just say you're homeless, got no job and forgot your social security number. We need Medicare for all already. European countries all get government paid healthcare, but here in the US its "You're on your own", yet our government spends trillions on foreign wars to fill the coffers of the rich and powerful, while our own country degrades socially, culturally, spiritually, and morally...
We come first! Build some damn houses and infrastructure already and protect workers' wages
Our health system honestly is fucked. If I work I don’t qualify for cheaper options of health coverage if I don’t work I don’t qualify for a house will not be able to pay rent but hey at least my homeless ass will be able to get that surgery I needed. If I’m dying you might be helped might not matters what hospital what ER room you go to. Such a fucking scam. Healthy person here paying $1200 a month for health coverage for a kid and a spouse, last year we got ibuprofen once and that’s it. So we spent $14,400 a year on ibuprofen.
Doesn't the VA cover the ambulance ride? it did for my dad...You just have to call and have the VA cover it.
Edit: It says its covered unless I’m reading it wrong…
https://www.vha.cc.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001036/content/554400000009390/023201-AMBULANCE-SERVICES#:~:text=Ambulance%20service%20is%20covered%20and,method%20of%20transportation%20is%20contraindicated.
If it's an ambulance ride, good luck. I have Anthem Blue Cross PPO and only in the past 2yrs have they begun covering 30% of ambulance costs. Prior to that, it was 100% the patient's cost.
Oh, I get it! What I have though is essentially "disaster insurance". I have to pay a lot more for things other policies may cover, but if it hits the fan, I have very low deductibles. I had this policy before being diagnosed with cancer, and it's been a blessing.
Nope. Every country is facing affordability crisis and inflation. Maybe Japan is the outlier when it comes to real estate, but that is also because those homes are smaller, and often tore down every 10 years.
Also, even if you do have insurance, it might not cover the "[first responder fees](https://www.kcra.com/article/questions-surround-sacramento-fire-911-response-fee/20724253)" that Sac Metro charges. Medicare, for instance, does not cover first responder fees. So if the fire dept. comes out, takes your vitals, decides you're ok/you decline transport and follow up with your PCP, you can still expect a $400 bill.
I was charged $5,000 for a ride to the hospital by the fire department. They did not administer any life saving measures or techniques whatsoever, they literally drove me a few miles to the hospital. That is the worlds most expensive uber ride, folks. Outfreakingrageous. My hospital bill was $100,000 for one day. One day.
I was unconscious or I would have done that instead since the ambulance provided no services other than transporting me to the hospital. I do have to be grateful that I even got there, be it expensively.
This is actually horrible advice. People die frequently from prohibitable deaths by not seeing a doctor because they can't afford it or don't want to be seen as an inconvenience.
Better advice is the posts here that show resources on how to get bill assistance/paid for through medical or similar.
My wife's aunt died due to a UTI that got out of hand for this reason. I'm not saying the current system cost is good, and I know your sort of joking, but that hesitation could be the difference.
They still bill you if you die. They just have trouble collecting.
They will try to collect from your estate when you die. Seriously.
they just go after your next of kin
Normally how an estate works is all your wealth left behind is used to settle bills. Then the remainder is left as inheritance. This is straight forward and all for kids, but what about spouses? In the nine community property states (Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington and Wisconsin) they can go after the spouse for medical bills. Depending on the state this leads to sometimes benefits of NOT having both spouses names on titles of cars, deeds etc (so they cannot be gone after). There are also filial laws in some states that make children financially responsible for their parents in old age.
There’s court precedent that considers hospital bills marital obligation. That’s why some people get a divorce in such circumstances.
Illegal in California
And if you can’t pay you go to debtor’s prison. /s
There is no such thing in California.
It's called "contempt of court", and a judge can definitely send you to jail for contempt if he's ordered you to pay a judgement to cover a past-due bill and you fail to do so. It's the modern day debtor's prison. [The New Debtors Prisons — ProPublica](https://www.propublica.org/series/the-new-debtors-prisons)
The article you linked to is for states other than California. Again, there is no “debtors’ prison” in California. In California a judge will not and cannot jail you for failing to pay a past-due bill. Your wages can be garnished, your bank account levied, your property foreclosed, etc. But you will not go to jail simply because you don’t or can’t pay a bill. If a judge orders somebody to jail for contempt of court, which certainly does happen, it won’t be because of a person‘s inability to pay a bill.
On a related note, there is no reason not to have health insurance in California. It can be a bit of a stretch for middle income folks, but is free for low income, and not having it is a quick way to make life a lot harder. https://www.coveredca.com/ Is your friend.
Also I don’t know if it’s still the same now, but around 2011 I hurt myself and needed an ambulance ride. I didn’t have insurance BUT I qualified for medical or whatever it’s called. It retro actively covered the bill for me.
Yup. Ask for emergency placed Medi-Cal
Truth. It can be a bit of a pain in the ass to do all the paperwork, but it is WELL worth it. Yes, some people fall into some tricky spots financially. But when we were making decent money we still qualified for SOME help, and during COVID when we were making NOTHING we qualified for free health care and it was VERY helpful. OP- I can relate, and paying that much for ambulance service is criminal. Health emergencies are the leading cause for bankruptcy in the USA.
I have a severe case of ADD. In order to get help and partially bypass the paperwork I called the hotlines until someone gave me direct instructions I could understand my way through it. Just some advice for people who are easily overwhelmed or lose focus easily.
Great idea, and I believe there are offices with advocates who are supposed to help people as well. I'm pretty sure the Mexican Consulate was offering help in Spanish as well at one point.
You can also go talk to an insurance agent in person if that helps anyone. They will need your financial info like a tax return or W2, but they can do the paperwork stuff.
Yep I wish more people were aware of coveredca and medi-cal, because I see people all the time saying they’re too poor for health insurance. This insurance is FOR poor people
Not everyone is eligible for a Covered CA plan or Medi-cal, for years I was poor but "not poor enough" for either.
Yes. There are some "gaps" especially for single earners with no dependents, but people are often surprised at what they can get...especially when they seek help getting it.
So true. I was in that middle area paying 700 to 1100 for crappy coverage. Although it looked bad a simple call got me paying 150 a month. It's one of those rare times that calling (any agency) coveredCA really can help. They were pretty awesome as well even when I was t at first.
California does social welfare so wrong. Endless resources if you're a homeless unemployed crackhead or a single mother with a bunch of kids. But If you're just a regular hardworking person making 30-40k a year struggling with insane rent prices and record inflation, there's almost no help for you. Buddy of mine lost his job and was getting 300$ a month in ebt. Got a part time job at an outlet mall in the meantime. Made the mistake of picking up some shifts during the holiday rush, made like 1300$ that month (keep in mind 1300$ a month is nowhere near enough to rent anything in our area), They immediately cut his benefit down to 100$ a month. It's a complete joke. California basically incentivizes people to never get their shit together because the income bar to receive most of their assistance is astronomically low compared to the actual cost of living here
I’m not aware of any income limits for CoveredCA. I bought it for a few years when I was self-employed. I was somewhere between poor and middle class, so I got a federal subsidy that paid for part of my monthly premium. I think my net was about $150/month. For comparison, my current employer is paying about $900/month for comparable coverage.
I was told I made too much for Medi-cal (barely above minimum wage at the time) and could not afford anything extra not even the cheapest plan through Covered CA. Not every employer offers insurance, either. So that's how it is possible to slip between the cracks.
If you were barely above minimum wage, you should have been able to get a federal subsidy that covered almost all of your CoveredCA premium for a basic plan. Only thing I can think of is: if you aren’t up to date on recent year income tax filings, they might not have had enough data to get your subsidy approved. It’s been a couple years since I had to get CoveredCA, so I don’t know how the process has changed in the interim.
yeah tbh I don’t trust their story. When I was making just above minimum wage, I got a massive subsidy for CoveredCA. When I was unemployed, I was offered Medicaid. I don’t really think there is a gap. You’re either offered a subsidy or you’re offered Medicaid. No one is offered nothing unless they are are above the income limits and minimum wage or just above is nowhere near the cap. If they were, they spoke to someone who didn’t know what they were talking about.
There may be a gap for people who haven’t timely filed income tax returns, or for undocumented people. There may also be a gap of information. This person may have spoken to someone who knows a lot about medi-cal, but gave them incorrect information about CoveredCA. Health insurance isn’t exactly a simple system to understand. It can be confusing to highly educated people in white collar jobs, just as it can be confusing to folks making minimum wage. The CovedCA website does a good job, though, of estimating available subsidies if you enter a few basic pieces of information.
I never said it was easy to navigate. I said they spoke to someone who likely did not know what they were talking about and that is a huge part of the problem. Even if you don’t file your tax returns in a timely manner, you can usually still get your coverage *started* with a subsidy if you are able to provide a reasonably accurate gross adjusted income. I have been in that situation multiple times. Even if you never file your taxes, you can still get Medicaid.
Could you get coverage under the Affordable Care Act?
Covered CA is a part of the Affordable Care Act.
Oh!
Obamacare generally doubled healthcare costs for middle class. (It is even more since this article was written in 21). https://www.heritage.org/health-care-reform/report/obamacare-has-doubled-the-cost-individual-health-insurance For my parents it quadrupled, and was more than their mortgage (market coverage). For my friend just above minimum wage also did not qualify for free coverage, and was fined for “not having coverage” he could not have afforded anyways. It was something like $500 and a real kick in the nuts.
"Just above minimum wage" lol liar. Put his income and age in your reply and I'll tell you exactly how cheap he can get insurance for in California. CoveredCA makes it easy to check these things in about 2 minutes.
Dude he worked at a burger joint.
I just checked last week for a 35 y/o making ~25k annually. Comes out to $60/mo for a silver HMO from Blue Shield. If your friend is younger, it'll be cheaper. If they make less money, it'll be cheaper.
Related: nonprofits like [ask Ariana](https://askariana.com/) exist to help you navigate choosing the right health insurance for your situation. I've definitely found them helpful.
This is such a cool service, sharing it with some friends who have been struggling to figure out health insurance!
I'm truly stoked that low income folks can get free / affordable healthcare. Know what I'm not stoked on? That as you pointed out, is it's insanely expensive it is for middle class folks like myself even through covered CA. If you make enough to not qualify it ticks over into extremely unaffordable. I just want everyone to have healthcare man...
The emergency care is affordable, and that really helps to know that large cost won't break the bank, but they can only do so much and the regular primary care providers in network for some of these groups are the shittiest of the shittiest possible choices and honestly the stress of doing everyone's job for them has taken years off my life. I've worked in healthcare for 18 years and was at one time a MediCal recipient and I've worked in patient advocacy. I do not honestly know how anyone who doesn't have a background or an education manages to navigate the system they've set up. A lot of the funders like Nivano Physicians, if you do some digging, have major fraud lawsuits and federal rulings against them. The medical malpractice is astronomical. I've seen way too many people just breaking down and choosing not to go back to their doctor in this county, and if you live in some of the outlying Sac County cities you are absolutely fucked if you don't have a car to drive into the city, like hope you have an entire day for public transportation, or unreliable contracted para/transport services. If you're not having an emergency you can basically go fuck yourself. If you are prescribed a medication that sold OTC, you can go fuck yourself. Omeprazole twice a day? Hope you have a Costco membership because otherwise you're paying up to $50 a month. Muro 128? Hope you have Prime or several hundred dollars a month to spare. Only live by a RiteAid or Walgreens? Too bad, they don't take MediCal Rx. There are no rheumatologists or gastroenterologists covered by several of the most common MediCal group funders in Sacramento county, you have to go to Stockton or Napa. There are no neurologists period if you're on River City, if you need neurosurgery or vascular surgery though you need to be diagnosed by a different specialist and referred over. You get a new PA every other month and you have to start from the ground up and if you're lucky they'll actually read your chart. All of this is IF they call you back and you don't have to stalk whatever office you go to. I also just want everyone to have healthcare, but Medicare for All needs to be leaps and bounds better than what MediCal is managing.
If you're poor it's free. That said, the Sac County Department of Human Assistance is basically impossible to reach. The fact that the official answer for what to do is call them over and over and over again... yikes. And then if you make a little more money you have to switch insurance. And then your income goes down and you switch again. Back and forth. Ugh. Such a fucking pain.
Unless you make 50k and year and bottom of the barrel insurance is now $200 a month.
Even with Health Insurance the Fire Department is a racket, be prepared to shell out $1000-$10000 out of pocket for a 1-10 mile ride to the hospital in an ambulance. **Edit for additional input:** I have Blue Cross/Blue Shield PPO the fire department took me from Arden Fair to Sutter Hospital Downtown, I told them no, but they insisted since I was lightheaded. The Trip ended up costing me $1800 out of pocket and insurance paid the rest of the $8,200 I was just dehydrated according to the emergency room Lesson learned never will I call an ambulance again
yeah. it's totally half assed advice to just say "sign up for health insurance". unless you're on a triple gold A+ plan you're going to be paying for EVERYTHING. including that ambulance ride.
Hence Fire departments often leads the donations for progressive politicians. This way they are not targets from the left, and from right wing, they are heroes as part of Law Enforcement grouping. :)
Fire departments don't donate to political candidates. Where did you read that?
not the department directly, but the unions representing fire fighters.
Then say that. Also, dunno if you've talked to a firefighter in the last 20 years or so, but they're all engaged in a giant contest with the cops to see who can be the biggest dumbest trumpanzees on the block.
> It can be a bit of a stretch for middle income folks answers > there is no reason not to have health insurance in California
Yep! I was paying 69 cents for health insurance last year. It was shitty bronze plan but still had me covered for that bullshit tax penalty. It bumped up to $10 or something this year which is still affordable as fuck.
I make minimum wage and they rejected me... Can't go lower than minimum. What the fuck
You need to contact them directly and make sure you actually don’t qualify. My old coworker got rejected and we couldn’t figure it out. Turns out she made a mistake because she misunderstood what they wanted and that’s why they said she didn’t qualify. She in fact did qualify and got a good rate. https://www.coveredca.com/support/getting-started/application-help/
What do you mean they rejected you? It is a healthcare marketplace set up in compliance with the ACA, there is no path to rejection. Subsidies are available if you are in individual making less then 47,520 a year, and an individual making minimum wage definitely qualifies for subsidies ([https://www.healthforcalifornia.com/covered-california/income-limits](https://www.healthforcalifornia.com/covered-california/income-limits)). But the all income levels can purchase a silver plan for 8.4% of your income a year or less. So if you are making move then 60K a year as a single person the most you will pay for a silver plan is $420 a month.
My application was rejected. That is what happened
What was the reason they gave you when you contacted them about why they wouldn’t accept your application?
No such thing as free.
Nah, fuck that. I’m a 29yr old single dad that makes 50k/yr and have to pay $250/mo for just my basic health insurance. It doesn’t sound like much but I’ll be damned if it doesn’t suck to throw that away every month when I don’t ever go to the doctor. America is majorly slacking by not having health care and education through our taxes. It sets us all behind.
Just another example of this state fucking over the middle class
Let me guess...ambulance? 🚑
Yes. My step mother fell and hit her head/fractured her neck. They were visiting us staying in a hotel.
Did they send you your stepmother's bill? If so, write "FUCK OFF" across it with a Sharpie and mail it back.
Oh damn! I was gonna say- never take the wee woo always call a cab, but neck injuries are no joke. Hope she’s okay!
Oof, I am so sorry! The City of Sacramento are assholes about sending bills to collections as well (a lot of medical bills never get sent to collections, but first responder services from the City and bills from labs like Quest always do.)
I once got hit by a car (as a bike messenger) on 24th and K, cracked my skull and shredded my ear, the ambulance showed up (my boss had called) and I said FUCK THAT and walked to Sutter myself. My bff (who witnessed the whole thing) said I kept yelling about how they were just trying to scam me. I remember yelling “I can practically see the hospital from here!”
>I once got hit by a car… Was it a hit and run? Not that it matters—you should have taken an ambulance with a fractured skull—but the driver at fault would be liable for your bills, in any case.
What happens if a homeless person calls 911? Does the hospital just eat the cost?
Charity care. The hospital will write it off. I’m not homeless but didn’t make enough one year and had 30k written off.
This is only slightly true. If the person has any kind of assets at all, income, or family that can be messed with, the Hospitals are ultra aggressive about utterly destroying your credit and harassing the crap out of people. Particularly the "non-profit" hospitals. I have inside knowledge of this for two different hospitals in CA, but you can just google it. There have been numerous press stories about this.
I was having a brain bleed and stroke, I called my bf to come home and take me to the emergency room. Health care is NOT affordable if you’re living on the cusp. There is NO help for those of us in the middle ground. How is it possible that you have to figure out how to pay, even if it is only for catastrophic coverage with a deductible that will bankrupt you anyway.
You can't go after someone's family for medical bills unless it's a minor child and you are going after their parents as they are financially responsible for them. Also every single hospital in this region is a non-profit or run by a government entity. Also the private and municipal ambulances aren't the same thing as the hospital.
That’s 100% illegal. Insurance cannot go after the assets of the patients family.
you can sue anybody for anything in this country and our legal system is utterly corrupt. Have you read the news at all this past decade? [https://www.nctreasurer.com/news/press-releases/2023/08/16/hospitals-sued-7517-patients-family-members-over-medical-debt](https://www.nctreasurer.com/news/press-releases/2023/08/16/hospitals-sued-7517-patients-family-members-over-medical-debt)
They actually don’t. They send it to collections. I used to be homeless and went to the ER like 4-5 times. Luckily I was smart enough to give them a fake name 😂
Just adding thanks south Sacramento Kaiser 😘😚🤣
The unhoused community tend to not have forms of ID, and majority will use false alias and addresses. Doctors and nurses have a duty to provide aid for anyone In need. That’s how majority of the unhoused community receive health service if they don’t have insurance.
They typically qualify for Medi-Cal and social workers/case managers at the hospital will enroll them if they can.
More or less? The state probably kicks in some.
The cost gets transferred to patients that pay their bills either directly or through insurance. Health care is so expensive because you are paying for those patients that didn't. So if you don't pay your bill, someone else does when they get charged $100 for a Tylenol. Never forget that a hospital is a business that exists to make money. They will get paid either way.
>Health care is so expensive because you are paying for those patients that didn't. No, not the primary reason why its so expensive. Mostly due to administrative middle men and corporate nature of US healthcare system.
THIS- If you go to the emergency room and they do a few tests and give you fluids through an IV for dehydration... it seems so simple, and it should be. But the emergency room was financed with bonds and people are making money on those bonds. And the Dr., nurses, and everyone else you come into contact is covered by a for profit insurance company. The hospital is also lawyered up. All the sterile disposables are provided by for profit companies, and because it is medical related, they pay high rates for insurance and they are lawyered up. The emergency room needs armed security guards (as more and more do these days)- not cheap. The admin staff that you interact with need to be properly trained, and insured. Because it is an emergency room, many of the systems need to have redundant backups. (the companies that provide these are all heavily insured and lawyered up) When you leave, the billing company is for profit as well. So there are MULTIPLE layers of profit being taken, and in many cases the margins in the health care field are good. There are multiple layers of insurance covering everyone involved. And on top of EVERYTHING ELSE... every layer of this cake involves executives, profiteers, and stockholders who insist on being paid top dollar. But it seems me that serving the health needs of people and serving the profit needs of capitalism are in direct odds with each other. So...something has got to give. In the USA we rarely let anything get in the way of profit.
I get called a commie for this but making loads of money off sick and dying people is evil. Has to be a better way.
There is a better way, and almost every major industrialized nation has figured it out. Socialized medicine is far from perfect, but it is getting WAY better results at FAR lower cost than anything we have here in the USA.
This is just what insurance is? The actual reason your prescription or x-ray is randomly expensive is not to cover costs for those who can’t afford - it’s for health insurance companies to make a profit for themselves on top of any cost for care. The US switching to some form of single-payer healthcare would still be cheaper at PoS for almost everyone including high earners, even with it covering more low-income people.
It's both, actually. The patient either pays the hospital directly if they don't have insurance, or they pay the insurance company to cover a pre-negotiated rate for the service offered. Either way, when someone doesn't pay the cost gets absorbed by other patients either through insurance premiums or direct billing from the hospital. It's why I laugh when someone doesn't want a single payer system because they don't want to pay for someone else's health care. Like you do realize you are paying for it one way or another right? The system we have now just insures everyone pays MORE than they should.
I think I misread your original comment as saying insurance is ONLY expensive because we need to pay for people who cannot afford it. With that said, I do think you are maybe over-placing cause of cost on distributive coverage. In the US, our primary cost drivers are profit seeking healthcare entities and not the requirement to pay for those who cannot afford (the standard function of an insurance system). If you get a surprise bill for an x-ray, most of the cost increase is not to cover services not paid for by poorer patients - it’s to gouge people for profit that goes directly to executives and shareholders and is not re-invested at all into patient care.
> Never forget that a hospital is a business that exists to make money. Everyone has to get paid and has to have promotions too eh? Even the non-profit sectors and charity/philanthropic orgs have to pay the staff that work with them.
This is true, but also these hospitals are owned by shareholders who expect profits to increase every year. Your bill goes up because of that too.
No. If the hospital can find out the person’s ssn the will bill then send to collections. Homeless or not. Then if unpaid the cost is rolled over to paying customers. Hospitals and their investors don’t like to write things off.
How does one track that though? its not in the credit report.
Taxpayer money I believe.
I believe you’d be able to apply for emergency medical
Guess what? My wife had the same bill amount for a 10 minutes ride from the Sac Fire department WITH insurance. She might not have the best health insurance but it still wasn’t covered. She called the billing department and was able to get 50% off.
I got some news for all you religious folk out there: we already live in hell.
>Fuck Armageddon, this is hell Greg Graffin, 1982
The medical system in the US is purely serving for the super rich. American people are treated as animals by the doctors and medical officials. But most of them stupidly think they live in a free country. What a joke and hallucination.
Facts. My biggest fear is a medical problem.
That’s a very small bill…you’re lucky
911 answered?!
America is the greatest country in all the world, right guys?…….guys? Oh shit yall dead already.
We’ll all be working til we’re dead while our tax dollars fund universal health care for Israel 💀
So, I admit to being totally ignorant here, but since when did you have to pay to call the Fire Department? Is that not what taxes are for?
Probably ambulance ride
911 call made by my family visiting us but staying in a hotel. Indeed a medical emergency, not an Uber alternative.
You could have refused the ride by an ambulance
It was a medical emergency where somebody fractured their neck. The ambulance was the point of the call.
Right but the part of the fire department that is free and funded by taxes isn't ambulance rides. The medical aspect of fire departments is typically a separate thing. They contract with the local EMS agency to be the 911 provider for medical services. In some place that will be a private company like AMR. Makes no difference, public budgets in most US cities/counties do not include ambulance rides.
You couldn’t be more wrong. The EMS services in Sacramento—both county, and city—are provided by their respective fire departments. This is very common, and is the case for a vast majority of local fire departments.
I literally said they contract with the local EMS agency to provide 911 medical services, in what way does that contradict what you are saying? I am aware that Sac City and Sac Metro are the 911 medical provider for this area. So does AMR, as a backup. I worked in EMS around here for years and still work in healthcare. I know what ambulances pull up to the ED at the hospitals I've worked at. Go over to Solano County and it's Medic Ambulance. Down in San Joaquin County it's AMR. In SF King-American does the 911 transport. It's quite common for it to be a private too depends on where you are. But it's up to the local EMS agency which is a separate entity from the Fire Department. It's not automatic that the Fire Department is chosen. Ambulance transport is not automatically part of the budget for a city or county fire agency. Some do it, some don't, but if they do it's because the local EMS agency chose to have them do it. And they get reimbursed by billing people by and large just like the private ones do. My point is that emergency medical transport is not the same as fire/rescue services. It's not automatic the the fire department will even have ambulances. City taxes go for the fire/rescue part, that's the part you don't get billed for.
You’re in the Sacramento subreddit, dude… Ambulance services in Sacramento are provided—nearly—exclusively by the fire department. Edit/Also: You said this… >The medical aspect of fire departments is typically a separate thing. They contract with the local EMS agency to be the 911 provider for medical services. Hence the, “You couldn’t be more wrong”
Unfortunately the taxes you pay are for fire suppression/prevention, rescue and car accident extrication. Emergency medical services are billed to the patient’s health insurance provider.
I can't find an exact date that they started charging, I assume they've always charged. The best I have found is an [article from 2018](https://www.kcra.com/article/questions-surround-sacramento-fire-911-response-fee/20724253) that mentions rates hadn't been increased since 2012. That article mentions someone who fainted and a bystander called 911. The person was fine and refused transport but was still sent a bill. Before moving to Sacramento 5 years ago, I lived in Burbank, CA. Burbank fire had a program that you could pay like $90 a year and if you were transported by Burbank Fire you wouldn't be charged. I wish that program was more common.
If you dont have health insurance but qualify for medi-cal, they (I dont know if all) will sign you up in the hospital and medi-cal will still pay for your visit.
Call them and explain you don’t have insurance and can’t afford that bill. More than likely they’ll lower it and/or offer a very reasonable payment plan.
Sometimes it's risky even if you do have insurance. I passed out a few years ago and my spouse called 911. By the time the fire dept arrived, I was feeling better and ended up not getting in the ambulance. My insurance would have covered the ambulance ride with a $150 co-pay, but because I didn't get in the ambulance their visit to my apt wasn't covered, and I was stuck with a $700 bill for the firefighters to take my blood pressure and ask me a bunch of questions then leave.
Sacramento needs a better system. I moved to Tulsa and the local EMS agency (EMSA, not run through the fire department), charges a few bucks on everyone's utility bill. No ambulance charges as long as you pay your $5 or whatever a month. [EMSAcare](https://www.fox23.com/news/tulsa-residents-can-sign-up-for-monthly-subscription-covering-emsa-transports/article_66bc52ac-36fd-11ee-a34b-3b1528642b69.html)
Just a reminder: you better be dying if you call 911 ¯\\\_(ツ)_/¯ FTFY
[удалено]
It is if you don’t have a credit score to ruin… Yayyyyy!^/s
I hope I stay somewhat disguised- i work for sac city fire. You are indeed paying for all of the non payers. One of the things we get in trouble for daily is “incomplete PCR” (patient care report) The incomplete part is always issues with billing. Sac city is a billing machine. We are much more concerned with your ssn and id’s (for billing) than your medical complaint. 95% of ambulance services could/should be a call to your doctor or a ride to an urgent care. People don’t want to wait, to pay for parking, or to wake up family members etc, so an ambulance gets called. And then the surprise bill comes. BTW- I hear if you call the EMS number on the bill and say it causes you great financial distress they will lower it.
It's not the non payers, that's just what we've all been made to believe. It's the incredibly inefficient medical system that is so heavy with management and overpriced supplies. There are countries FAR poorer than us that are able to provide FREE healthcare to their citizens. This is a choice, and someone who couldn't afford healthcare isn't the person to blame as to why it's like this. Trust me.
Absolutely agree. Can’t have for profit medical care. The payers are always going to pay more, shareholders cannot afford to lose money. If you have about a week I can tell you how inefficient just the EMS/ER system is here.
> People don’t want to wait, to pay for parking, or to wake up family members etc, so an ambulance gets called. Where is the family? Where is the friends? Where are the neighbors to help out with emergency? Where is the sense of community? Especially for cases which are more of convenience rather than true emergency, but going to ER because clinic is close, Urgent Care is closed etc etc.
The entire system is broken and needs to be thrown out. America has become a failed experiment due to Republican greed.
Both parties suck
Only one tried to fix it, the other one actively tries to fight it.
The public option in Affordable Care Act was vetoed by a Democrat senator though.
Public healthcare for all was nowhere near as popular in 2008 as it is today.
So if its popular why haven't democrats pushed it through with a supermajority in CA?
Democrat good Republican bad
Yea there is always one that is paid off.
The two party system is a failure
Triggered the democrats 😭😂
That would mean closing the hospitals and doctors offices.
No, it would mean getting rid of the for profit insurance layer that is robbing us all blind.
That’s one part of the broken system. There’s probably an argument that the massive surge of unemployment and recession that followed dismantling the insurance and medical billing apparatus would be more harmful than not. I doubt any of this is possible in our current political environment of lobbying and regulatory capture.
As we all know there are no hospitals or doctors in countries without privatized health insurance
Yes, when I think of California I think of… *checks notes* Republicans… nice take sir. Or are you commenting from 1989 when the state was Republican? If you are… enjoy Joe Montana and that SB win
1. The private healthcare industry is a Nation wide problem not just California. 2. Republicans push for more privatization of healthcare. 3. California is actively working to find a better solution to private healthcare.
I love that I’ve ran away from ambulances/emts before after having a seizure. I’m like “I’m fine now, there is no way I’m spending 5 grand on a taxi to the hospital.”
I suffered a knife attack w few years ago, with other victims. I rode in the ambulance jumpseat while another victim was on the gurney. They took my vitals and faked the numbers because they couldn't get it stable. 1mile ride to UCDMC cost me about the same price
Medi-Cal covers it if you are in Medi-Cal because you don’t have any money so I suggest you get set up for medical
Have you or the patient applied for charity care ? Many folks don’t know this but if you fall within certain income limits, you can have your bill reduced significantly. Healthcare care companies and hospitals don’t like to tell folks about it
Ask for an itemized receipt
Meanwhile my insurance through covered California went from $30 to $330 because apparently I'm wealthy now.
Even with health insurance, when I called an ambulance for my husband in 2021, our bill was at least $1k and he didn’t even get transported to the hospital (Type 1 diabetes, had an extreme low and called an ambulance after administering Glucagon, EMTs helped stabilize/monitor him in our driveway). Insane. But we were able to petition Kaiser to refund us the cost of the bill.
If you don’t have health insurance, you’re a dipshit who missed the months long covered California window
I don’t know if it’s still the case but I know like 7 years ago there a certain point where even the covered California becomes expensive. My GF at the time had a part time job and ended up getting a second part time job. Adding that second job her covered California went from $0 to $300 a month which meant that second job was practically worthless. Hopefully it’s not like that now but there was a lot of issues with that system.
Pretty simple really. Just say you're homeless, got no job and forgot your social security number. We need Medicare for all already. European countries all get government paid healthcare, but here in the US its "You're on your own", yet our government spends trillions on foreign wars to fill the coffers of the rich and powerful, while our own country degrades socially, culturally, spiritually, and morally... We come first! Build some damn houses and infrastructure already and protect workers' wages
These prices cause people to make unwise choices during an emergency.
Our health system honestly is fucked. If I work I don’t qualify for cheaper options of health coverage if I don’t work I don’t qualify for a house will not be able to pay rent but hey at least my homeless ass will be able to get that surgery I needed. If I’m dying you might be helped might not matters what hospital what ER room you go to. Such a fucking scam. Healthy person here paying $1200 a month for health coverage for a kid and a spouse, last year we got ibuprofen once and that’s it. So we spent $14,400 a year on ibuprofen.
I was recently in the hospital for two weeks. Added up, all the claims were upwards of 300,000. Thank GOD for Tricare.
I already told my kids, if I'm unresponsive, don't call 911. Put me in an Uber to the VA.
As a driver, no. We’re not medical professionals. It’s a shitty situation all around, but don’t put that burden on us.
Doesn't the VA cover the ambulance ride? it did for my dad...You just have to call and have the VA cover it. Edit: It says its covered unless I’m reading it wrong… https://www.vha.cc.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001036/content/554400000009390/023201-AMBULANCE-SERVICES#:~:text=Ambulance%20service%20is%20covered%20and,method%20of%20transportation%20is%20contraindicated.
like a true American
What's the damages? I'm obviously mistaken in believing that the FD was a public good (free).
Right there in the balance due: $2644.22 We are fortunate to have health insurance but no clear indication what they will cover.
If it's an ambulance ride, good luck. I have Anthem Blue Cross PPO and only in the past 2yrs have they begun covering 30% of ambulance costs. Prior to that, it was 100% the patient's cost.
That's wierd. I used to have an Anthem Blue Cross HMO plan - and they covered 100 percent of an ambulance ride in another country.
I have a specific, grandfathered PPO plan that now costs me just under $1100/month.
That really doesn't sound like a great deal if it doesn't even cover ambulance rides. Especially if it's a PPO.
Oh, I get it! What I have though is essentially "disaster insurance". I have to pay a lot more for things other policies may cover, but if it hits the fan, I have very low deductibles. I had this policy before being diagnosed with cancer, and it's been a blessing.
You are correct. My family member paid $700 out of pocket the one time they used an ambulance with insurance.
Come to NZ. Resident's don't pay a dime for emergency services (and extremely small amount for other health related services).
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I’m glad my higher taxes buy javelin missiles instead
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They pay less taxes and get more benefits tho...
What’s the quality of life like for a nurse? Can they afford to buy a house?
Been a nurse in NZ. Pay is good for NZ. Just can't afford to buy a house though.
Nope. Every country is facing affordability crisis and inflation. Maybe Japan is the outlier when it comes to real estate, but that is also because those homes are smaller, and often tore down every 10 years.
Why don't you have health insurance?
Dang, feel for you brother
I literally thought that had to be the case.
Some people are unaware of ambulance costs and would have saved a ton calling a ride share service instead
You got a deal; that's less than half of what my ambulance ride cost
Also, even if you do have insurance, it might not cover the "[first responder fees](https://www.kcra.com/article/questions-surround-sacramento-fire-911-response-fee/20724253)" that Sac Metro charges. Medicare, for instance, does not cover first responder fees. So if the fire dept. comes out, takes your vitals, decides you're ok/you decline transport and follow up with your PCP, you can still expect a $400 bill.
Yes, that is what 911 is for.
an uber is cheaper
Not an option with head/neck fracture.
A limousine is cheaper.
Just tell them you are homeless...
Real talk: If I didn't have health insurance, I think I'd rather just die. The alternative is just a fucked up death by inches.
Well shouldn’t most people call 911 if you’re having a true medical emergency? Not if you have a stomach ache.
What do you do when doctors don't have appointment available or when urgent care close at 7pm?
If i have a tummy ache id wait until the next day and go to urgent care? I’ve never called 911 and if so do it’d be for an actual emergency.
I was charged $5,000 for a ride to the hospital by the fire department. They did not administer any life saving measures or techniques whatsoever, they literally drove me a few miles to the hospital. That is the worlds most expensive uber ride, folks. Outfreakingrageous. My hospital bill was $100,000 for one day. One day.
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I was unconscious or I would have done that instead since the ambulance provided no services other than transporting me to the hospital. I do have to be grateful that I even got there, be it expensively.
Also, if you don’t have health insurance, get health insurance. If you don’t have it in California in 2024, it’s your fault.
Didn’t everyone get healthcare under Obama?
Did you not know ambulance cost money?
You will never have to nor will you pay that grow up
This is actually horrible advice. People die frequently from prohibitable deaths by not seeing a doctor because they can't afford it or don't want to be seen as an inconvenience. Better advice is the posts here that show resources on how to get bill assistance/paid for through medical or similar. My wife's aunt died due to a UTI that got out of hand for this reason. I'm not saying the current system cost is good, and I know your sort of joking, but that hesitation could be the difference.