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November 2, 2011 5:28 PM

Mom: Cancer + unemployed + broke. Just shy of Medicare eligibility. She needs help immediately. But how? (Cook County, IL)

Cook County, Illinois: My mother is 64, unemployed, and has no savings. She's just been diagnosed with anal cancer and needs a CAT scan right away to determine the stage.

She's not eligible for Medicare until February. A Medicaid application takes 45 days to process, and obviously we can't wait that long. The social worker at her current hospital (Sherman) isn't calling her back, and she can't get answers from anyone.

Her twin sister died from this same cancer three years ago due to lack of money and sub-standard care, so you can imagine she's absolutely dizzy with fear right now. I'm an artist and live hand-to-mouth, so I simply don't have anything to give her but love, support, and information. I also live in Los Angeles and I'm trying to handle all this from afar, despite knowing nothing about this whole system or process.

What can she and I do right now - not the "one week" now, not the "two months" now, but now - to ensure that she gets a scan, gets a diagnosis, and gets treated? Where can we go, who can we call, what are the local and federal resources that we aren't thinking of? Good hospitals, charitable organizations, financial assistance?

Lay it all on me, please.

posted by mykescipark to health & fitness (25 answers total)

If you want her to get a scan, get a diagnosis, and get treated, right now, she needs to go to an emergency room. They cannot turn patients away due to inability to pay. Deal with the money later; if she has a cancer that even in a best-case scenario is usually fatal (and was for your aunt), I frankly wouldn't worry about money at all. Just have her go to the ER.
posted by juniperesque at 5:53 PM on November 2, 2011 [3 favorites]

How recently unemployed? Is she COBRA eligible?
posted by PorcineWithMe at 6:04 PM on November 2, 2011

You can call the billing department at the hospital directly rather than wait for the social worker, and get quotes for the scan, work out the beginnings of a payment plan, and then do what you can to raise money from friends, family, nonprofits, government organizations, etc. Get the CAT scan, and take it from there.
posted by judith at 6:07 PM on November 2, 2011

Take a look at the Illinois website Illinois Healthcare and Family Services and see if anything applies, including CHIP. I would call every program listed. Good luck.
posted by shoesietart at 6:08 PM on November 2, 2011

You can check with all of the local hospitals and see if any have charity programs for those without insurance. These programs might be specific to cancer, or even types of cancer. Someone I know did this when she had breast cancer. The hospital automatically lowered the cost of treatment, then let her pay off the thousands of dollars she still owed $50 per month.
posted by BlahLaLa at 6:15 PM on November 2, 2011

This sounds like the best reason you'll ever have to run up $24,000 of credit card debt. If you're an artist living hand to mouth you probably aren't using your credit score for anything anyhow.
posted by bq at 6:20 PM on November 2, 2011

I started receiving social security at age 62. Check with your local social security office to make sure.
posted by JayRwv at 6:24 PM on November 2, 2011

Thanks so far everyone.

If she goes to an emergency room, aren't they just going to detect the cancer, schedule a biopsy, and put her in the same position she's in now? I wouldn't think they'd just rush her into a CAT scan because she says so.

She's been unemployed for four years - since she had to quit her job to care for her sister once they couldn't afford proper hospice care.

My own credit is literally not an option. You really just have to trust me on that.
posted by mykescipark at 6:39 PM on November 2, 2011

Advocate Christ will cover up to 100% of hospital charges for patients in need. Apply here.

Little Company of Mary has a charity care policy, too.

Here is St Bernard Hospital's application for financial assistance. Here is Roseland's.

I hope this helps. Very best wishes to you and your mother.
posted by rdc at 6:40 PM on November 2, 2011 [5 favorites]

I am not saying that your mother is eligible for Medicaid. I am not a Medicaid expert. But according to Illinois Legal Aid, Medicaid coverage of incurred medical bills can be granted retroactively, up to 3 full months before the date that you apply, as long as you met the eligibility criteria during that period.

Again, I am not saying that your mom will qualify for Medicaid or that Medicaid will cover everything; I don't know that. But I would read the hell out of that page and call Illinois Legal Aid and see what they say.
posted by Snarl Furillo at 6:50 PM on November 2, 2011 [3 favorites]

She needs to go to an emergency room and most likely she will be available for STAT care, she might have to have pain, etc but whatever it takes for emergency care. It's called a safety net
posted by femmme at 7:29 PM on November 2, 2011

If you haven't, check with her local agency on aging. Age Options covers suburban Cook County (I'm sure they can refer her if she's in a different part of the county.)

People there should be able to help you do what others have suggested you do yourself: Figure out what services she might be eligible for and who to contact to get those services.

"AgeOptions – together with a network of organizations – connects older adults with a wide range of services and programs. They include in-home care and adult day services; telephone and in-person assistance; resources and education; and nutrition and health care programs."

Also, you say the social worker won't call her back. Might that social worker respond more promptly to a mightily pissed off child who's going to bug the hell out of everyone at the hospital until she gets the treatment she needs?

Best wishes, and your mother is lucky she has you as an advocate.
posted by Mr.Know-it-some at 7:36 PM on November 2, 2011 [1 favorite]

There is safety net health care for people without any form of insurance, but you have to go looking for it. Call around to find out what your mother's options are and do some research on which of the affordable alternatives is likely to provide the highest quality care.

One place to start is with the Cook County Health & Hospitals system, whose mission is "to provide healthcare with dignity and respect regardless of a patient’s ability to pay." They have their own financial assistance programs as well as resources for applying to other programs. That info is on this page.

You can also search for safety-net health services near your mother's location on this HRSA site.

You can also call your mother's city or county health department and ask them for information about low- or no-cost health care for the uninsured. If all else fails, call the office of the health director/commissioner and ask the person in charge for help, as he/she will have connections you do not and may be willing to use them on behalf of a desperate constituent.
posted by unsub at 9:15 PM on November 2, 2011 [1 favorite]

Ditto ditto ditto to finding low-cost or free health care. You should be able to ask hospitals around her area if they offer such a thing.

Also, I second the ER.... this is a dire emergency...she needs to have proper medical care. Worry about the costs later. They can be reduced and later written off after she is put on Medicaid or whatever else you find she's eligible for...she should get something considering her age and status.
posted by camylanded at 9:59 PM on November 2, 2011

I don't know if this would be quick enough to help you but Needy Meds has a list of free/low cost clinics for IL. They also have links to State sponsored programs. Maybe it could help with treatment. Best of luck to you and your mom!

http://www.needymeds.org/free_clinics.taf?_function=list&state=il

Disease-Based Assistance Programs (Cancer)

http://www.needymeds.org/copay_diseases.taf?_function=summary&disease_id=43&disease_eng=Cancer%20-%20All&dx=20
posted by stray thoughts at 11:20 PM on November 2, 2011

I would call her representatives in Congress, the Senate, the city, the county and the state legislature and tell them she needs help ASAP. That can be very hit-or-miss, but in some cases, one motivated person in one legislators' office can get a lot done real fast.
posted by ambient2 at 12:52 AM on November 3, 2011

For future reference, my mom was just diagnosed with cancer and apparently University of Chicago does not accept Medicare (or so they told us), so even when she gets it, that's not an option.
posted by IndigoRain at 2:35 AM on November 3, 2011

apparently University of Chicago does not accept Medicare (or so they told us)

That is false.

she needs to go to an emergency room

ERs are obligated to stabilize patients in urgent distress, not provide longer term care.

But I would read the hell out of that page and call Illinois Legal Aid and see what they say.

Yes, hospitals routinely ascertain eligibility for Medicaid and provide service. Sorry that the social worker is ignoring you; she may need to contact a different hospital or bother the existing one repeatedly.
posted by a robot made out of meat at 7:34 AM on November 3, 2011

Please ignore everyone who is telling you to go to the emergency room. The ER is not an oncology ward, unfortunately. Your mom might be able to somehow get the CT scan done there, but I seriously doubt it. And even if you could, that wouldn't be of benefit - she needs treatment in addition to more diagnostic information.

I would contact local hospitals and speak to their eligibility staff. Identify your mother as a "self-pay" patient. Here are some places to start:

Roseland Community - link to application for financial assistance

Advocare Health - charity and financial assistance guidelines

St. Bernard - patient financial services

Little Company of Mary Hospital - financial assistance

Every hospital in the Chicago area should have a page like this. There's usually a link to the Financial Asisstance page right on the main page.

You can also call the high risk pool plan for Illinois.

Good luck.
posted by pecanpies at 8:39 AM on November 3, 2011 [2 favorites]

Hi,
Illinois Legal Aid is a website and resource directory, not a legal aid office. Call the Legal Assistance Foundation at 312 341 1070- they can help you negotiate with hospitals about medical bills. Also call LAF's Public Benefits Hotline [phone] (toll-free) now. She should apply for both Medicaid and Social Security (SSI and/or SSDI).
posted by steinwald at 10:56 AM on November 3, 2011

Just reiterating that everyone who thinks that ER is the answer here has no idea of A) what ERs are and are not literally equipped to do in this situation and B) the complexity that is involved in testing (and analysis of those tests) to determine cancer stage and begin treatment. I went through cancer treatment for a little over a year, during which I had a couple of trips to the ER, and all they could do was stabilize me and make sure that my immediate symptoms weren't indicative of a major complication for which I needed to be admitted to the hospital. The actual facilities, machinery, technicians, and doctors that are used at any hospital to determine cancer stage, determine a treatment plan, and start administering treatment are not located in the emergency room and cannot be accessed simply by showing up at the emergency room.
posted by scody at 2:08 PM on November 3, 2011 [1 favorite]

oh, and the time it took from diagnosis until my first day of treatment actually began was nearly 6 weeks -- because it took that many tests, appointments, consultations, etc. (not to mention some emergency dental work that they wanted me to get out of the way first for the sake of my immune system) to get from point A (diagnosis) to B (first day of radiation). And that's not because I wasn't a fairly urgent case; they didn't know if I was Stage II or Stage III at that point or how aggressive the cancer was, so that 6 week interim period happened even as I had an entire medical team basically shifting into high gear to get me into treatment ASAP. No ER on the planet can do any of that.

I say this also to the OP as, perhaps, a way of letting yourself catch your breath. Yes, she needs treatment urgently, and the financial/insurance situation makes that an even more complex task than it already is. But even with money and insurance it's quite possible she wouldn't necessarily be getting a scan tomorrow and starting treatment on Monday, so try to get that fear/anger out of your head if you can. Even under the best circumstances, "ASAP" may be a week or two till she can get that scan (I know, it feels crazy and terrifying to have to wait for these things at all when you have every good reason for desperately wanting them to happen right now.)

So I would call all the resources pecanpies and steinwald suggest; I would also suggest calling the social worker's office at the hospital yourself and, if you get no answer, escalating however you can to talk to a supervisor. (My technique in these sorts of situations is to start calling whatever general information number(s) I might have that will allow me to speak to an actual human being, then -- in a combination of being very, very polite and very, very intent of getting an answer -- I start off by saying "I'm hoping you can help me, and if you can't if you'd be so kind as to connect me directly to whoever I should be speaking with. [Insert one sentence precis of the immediate situation here.]" Then I ask a question that can't be answered with a yes or no -- e.g., "who should I speak to in order to make sure my mother's social worker calls her back by Monday?" Write down the names and dates/times of every single call you make.)

All of this is to say that you and your mom are entering a process that's going to be, well, a process. Stay as calm as you can (I know, insane, right?) and just take it one step at a time. I wish you and your mom all the best.
posted by scody at 2:51 PM on November 3, 2011

Oh, and one more getting-answers-on-the-phone-come-hell-or-highwater technique: if you ask a question that receives an "I don't know" in response (and no further help seems forthcoming), don't let it dead end you. Just say "okay, thanks. Who should I talk to who would know?" That might at least get you referred to another office or bumped up to a supervisor.
posted by scody at 2:54 PM on November 3, 2011 [1 favorite]

Cook County has a public hospital system that largely serves the uninsured/underinsured. See this link about how to access their services.
posted by Wordwoman at 8:46 PM on November 3, 2011

a robot made out of meat: "apparently University of Chicago does not accept Medicare (or so they told us)

That is false."

Medicare was going to kick U of C out because they let someone die in the ER without being seen as well as another preventable death. They have also come "dangerously close" to violating EMTALA.

Perhaps they were never actually kicked out, or got reinstated, but they refused to treat my mother.

In any event, I asked my mother for what exactly happened. While Medicare said that she could go there for a consult ONLY, the doctor said that because she could not get her treatment there, he refused to see her. Either way she was unable to get treatment there, resulting in us having to go three times farther away to Indiana University. (Her cancer is rare and best treated at a university.)
posted by IndigoRain at 3:20 AM on November 6, 2011