How Do You Handle Ovarian Problems On No Insurance?

December 23, 2006 7:34 PM

Girlfriend has been told by doctor to have a vaginal ultrasound. He suspects either an ovarian cyst or endometriosis. We live in Seattle; she has no health insurance. Options & advice?

She's had pain for over a year. We went to a public clinic several months ago, where the doctor thought it was either an STD (that came back negative)... later we thought it was radiating back pain or something.

On a trip back east, her mom took her to her doctor for a pap smear & such... doctor came up with this guidance.

So. She's scared to death (family history of cancer), but everything I've read on this & known from other people says this is generally treatable stuff. We just have to figure out how to do it.

Is there genuine low-cost health insurance that'll help? She's had it this long... I figure we need to diagnose & treat right away. But I'm low on cash reserves, she's not working. There's gotta be a way, though.

What do we do? Is there someone we can sign up with? Who do I call?

posted by scaryblackdeath to health & fitness (8 comments total)

Was the clinic you went through the 45th Street Clinic? If not, call them up and make an appointment for a regular GYN appointment. They used to be able to give you referrals over to Harborview and/or Swedish if you needed further medical treatment and have financial need. They can also give you advice re: health insurance options if your girlfriend requires ongoing treatment or care. When I lived in Seattle I had whatever the state-sponsored insurance was and I paid very little when I was low income [free to $20-30/mo] so do check it out, Last time I checked there was a long waiting list but there may be some interim option or there is WSHIP if you have been denied coverage.

I probably don't need to tell you this, but getting on top of this soon if there is in fact a problem is really a good way to mitigate possible long term issues, so think of the money and time you might be spending now as potentially limiting time and money you'd be spending later.
posted by jessamyn at 7:43 PM on December 23, 2006

I'm willing to spend whatever I've got. The trouble is, that's not all that much. I can handle medical bills in the hundreds, short term, but not in the long term. And not thousands.
posted by scaryblackdeath at 7:55 PM on December 23, 2006

Getting it taken care of now, while the problem is (hopefully) minor, will almost certainly be cheaper than having it taken care of if it gets worse. I speak from experience - in the two months it took between an ultrasound from my family doctor, to referring me to a GYN and having her ultrasound it, my ovarian cyst doubled in size and I ended up losing a fallopian tube.

If your income is low enough, you might qualify for emergency healthcare for the indigent. I did, even though I was working at the time.
posted by IndigoRain at 8:30 PM on December 23, 2006

Go to Planned Parenthood, I had this exact procedure done for free because I was low income. They have Federal grants and such she can get and Planned Parenthood has a generous sliding scale.
posted by yodelingisfun at 10:34 PM on December 23, 2006

First she needs to get a referal from the other doctor that she needs this so that you dont end up paying for the initial consultation that has already happened. Even if you go to a regular gyno it should be about a few hundred dollars, and alot of doctors will definately work out some sort of payment plan with you. Also ask if you can pay what they would pay the insurance company because that is always a much lower rate than you would pay without it. You may get an attitude about it, but you might not.

Either way, the sooner the better. If she does have a cyst it could be incredibly easy to get rid of, but depending on the nature of the cyst it could cause her alot of pain or be toxic to her body in the possibility of it bursting. Its much more likely though that it will go away on its own or with the hormones in birth control.
posted by trishthedish at 6:47 AM on December 24, 2006

Another resource (though I don't know whether they do what she needs): Country Doctor Community Health Clinic.
posted by ottereroticist at 8:09 AM on December 24, 2006

Get coverage of ANY kind, no matter how cheap and high deductible the plan is. Do it BEFORE you go in, and soon.

Working in insurance, I can tell you that Doctors charge WAY more then it costs them to do something. Insurance companies tell them, "you're only allowed to charge X for that service" (see: usual and customary or maximum allowable fee). So a bill that a Doctor would charge out for $100,000 ends up only costing the insurance company (or insurance subscriber) $10,000. I see this every single day. Someone who doesn't have insurance ends up getting the $100,000 bill, that it will take them the rest of their lives to pay off, and in reality it shouldn't have cost nearly that much.

I say get the insurance now, before she gets the diagnosis if you can, because if she is diagnosed beforehand and you find out its endometriosis, that's a lifetime (or near lifetime) condition, and if you were to get insurance after she was diagnosed, you'd have about a year before your insurance would cover anything related to it (see: pre-existing condition).

Even if your employer doesn't offer health insurance, there are individual plans available. I would link you to the company that I work for, but evidently they don't write individual policies out of WA, and I'd hate to be accused of shilling. You can email me if you have any other questions. Email in profile, etc.
posted by gregschoen at 10:00 AM on December 24, 2006

I have also worked in health insurance. Along the lines of what gregschoen said above: if you cannot get coverage, you may be able to bargain prices with the health care provider. Because they are only expecting to get (using gregschoen's example) $10,000 for that $100,000 procedure, you may be successful in telling them that you can only afford to pay a percentage of what they want to charge you. I have known people who were able to bargain down prices with health care providers, even before they received the care. It's worth it to call around places and see what they will allow you to do.
posted by veronitron at 10:39 AM on December 24, 2006