FAQ for the Uninsured and Under-insured

Here’s the answers to your questions about how you can benefit from the program

Does Lehigh Valley Health Network care for people who do not have the ability to pay?

Yes. In each of the last four years, the health network has provided more than $4.8 million in free care to the community. However, that’s only a portion of the care provided that the health network was not compensated for. Annually, more than $11 million in care is provided to patients who ignore or refuse to pay their medical bills. Many of these patients would have qualified for financial assistance, but failed to apply.

If the health network offers free care, why do I need insurance?

We do not encourage people to seek free care. However, we are here to help you afford quality care. Having a comprehensive insurance plan has become a luxury. It provides peace of mind. Plus, it makes a visit to a hospital or doctor’s office easy. All you need to do is sign your name and you’re covered.

Unfortunately, some people can’t afford this luxury. Those who can’t, and need our help, must go through a process. Paperwork must be filled out and all applicants will be screened for eligibility. Some may not qualify. If you have the opportunity to be insured, take advantage of it. It’s always the wiser choice.

Do I qualify for financial assistance at the health network?

If you are uninsured or under-insured, you may qualify for free care or care at a reduced cost. We are the only local hospital to offer a reduced cost program to families with a household income four times greater than federal poverty guidelines.

For example, a patient in an uninsured or under-insured family of four with an annual household income of $80,000 can receive a 99 percent reduction on the cost of any care exceeding $50,000. That means the patient would be responsible to pay only $500 on a $50,000 bill.

Larger families and those with less income are eligible for larger deductions in their medical bills. For example, if the same family of four had an annual household income of $40,000, the same care would be provided free of charge.

I’m uninsured and single. Do I qualify?

An uninsured or under-insured single earning less than $40,000 a year could qualify for free or reduced-cost care.

Is there help available when applying for financial assistance?

Everyone that comes to us for help with their hospital bills must first fill out an application for medical assistance from the state. To serve you better, we have taken on the expense of contracting with Physician and Tactical Healthcare Services (PATHS), a company that helps patients through the application process and helps people find an insurance plan they can afford.  A PATHS representative is assigned to our emergency departments full-time.

If you don’t qualify for medical assistance from the state, the health network has six financial counselors on staff to help you apply for our reduced cost of care program. Counselors are available to meet with you face-to-face to privately discuss you financial situation. They’ll help you fill out the paperwork and will do whatever they can to ensure you qualify for financial assistance.

What happens if I need emergency care but have no insurance?

The health network helps every patient who walks through its emergency room doors. If you need immediate medical attention, we’ll treat you first and discuss your ability to pay later. Physicians and caregivers do not know your insurance status. Every patient is guaranteed to receive the same quality of care.

If you don’t have insurance, all you need to do is tell the emergency department receptionist. You’ll be referred to a financial counselor who will help you fill out the necessary paperwork for our reduced cost of care program.

The emergency department physician told me to see a doctor in two weeks. I don’t have insurance. What should I do?

If you need a follow-up visit, a financial counselor will make you an appointment at one of our clinics, where you may qualify for free care. If you don’t qualify, you’ll have to pay a minimal co-pay. Your financial counselor will determine the amount.

If I’m uninsured, can I get a discount on bills I receive from a private practice physician?

More and more private practice physicians associated with the health network are honoring reduced cost of care applications. However, not all of them do. Our financial counselors often work with them to get you a discount on your medical bills. In the future, ask your physician if they honor our discount applications.

I’m self-employed. I need surgery and I know my insurance plan won’t cover me 100 percent. What should I do?

You should come to our hospital for your surgery. Like many Americans, you fall in the under-insured category. Your insurance company may only pay a portion of your medical expenses, leaving you with the responsibility to pay the difference. If you’re eligible, our reduce cost of care program may help you significantly lessen the amount you owe or may even totally forgive your balance.

I’m self-employed, make a reasonable wage but can’t afford insurance. Can I get a reduction on my medical bills?

Yes. We offer generous discounts to anyone who has to pay out of their own pocket. If this applies to you, you’ll automatically receive a 67 percent reduction on your medical expenses just by filling out an application for reduced-cost discounts. Most hospitals don’t even come close to offering such a generous discount to people who are uninsured.

I have a serious disease and no insurance company will give me coverage. Will you care for me?

Yes. Remember, we’ve made a promise to care for every person, regardless of their ability to pay. A PATHS representative will help you look for an insurance company that will offer you coverage. Plus, our financial counselors will work with you to find an affordable way for you to receive the care you need.

I’m living in the U.S. illegally. Will I be reported to the authorities if I go to the health network for care?

This page last updated 12/14/08 04:41 PM