Health Care Hustlin': Advice for the Uninsured

When I was in the ninth grade, my dad lost his job and our family no longer had health insurance. I attended a private, religious school on a massive scholarship. Growing up among rich kids, I was mortified that I couldn’t go to the doctor. Because I’ve always struggled with anxiety when it comes to money, this embarrassment led to hypochondria. As soon as I could not longer get health care, I developed every ailment in the world. That’s when I started using my anatomy and physiology teacher Mr. Klawsky as a health-care provider.

“Hey Mr. Klawsky,” I’d say, poking my head into his lab classroom. “Let’s say I had some pain on the left side of my stomach like, right here,” I’d say, pointing to my lower abdomen. “Would that be like, my kidney and also what can I do to make it not hurt?”

“Mr. K, hey!” I’d say, my face pressed against the glass window of the teacher’s lounge. “If I have this weird bump on my knee and it hurts, should I just ice it or do I have knee cancer? Also, is knee cancer a thing you can have?”

“Gaby,” he’d reply, exasperated. “Once again, I am not a doctor. I can’t legally diagnose you.”

“Right,” I’d say. “But like, my ear is kind of ringing, and what if I have scurvy?”

Eventually my dad found another job and we had health insurance again. But my time spent with Mr. Klawsky taught me to be resourceful about health care. This came in handy recently, when I became part of the 25 percent of 18-to-25-year-olds who are uninsured. Here are some things I learned:

Use Living Social to see a dentist. The same websites that offer discounted massages and gym memberships can also get you cheap dentist appointments. The only problem with these Groupon-type deals is they can be a way for the doctors offices to get you in and then scam you for more procedures. Stand firm. I checked over and over again that everything they were doing was covered by the coupon. It cost $80 for a teeth cleaning. The dentist tried to talk me into multiple other procedures, for $500 or more.

Don’t let them get you. Get in, get what’s on the coupon, and get out.

Find a therapist on a sliding scale. I live with depression, anxiety, and hypomania, and when I was uninsured, I thought that without health insurance I’d never be able to afford to treat my conditions.

I was wrong. A quick Google search of “sliding scale therapy nyc” led me to OCMH, a fantastic group that does therapy on a sliding scale according to your income. I see someone for 90 minutes for $80, or 60 minutes for $40, depending on how my week is going income-wise. My therapist is a psychology student working toward the hours he needs to graduate. I assumed paying less for therapy meant the care wouldn’t be as good, but that’s not true. It’s been a huge help and hasn’t taken the big chunk out of my bank account I thought it would.

Seek addiction treatment online. My father is a recovering addict and alcoholic who, during the time my family was uninsured, spent most of his days at free Alcoholics Anonymous meetings. But for addiction recovery, there’s a newer free site called In the Rooms. It’s like Facebook for addicts and alcoholics, but the best feature is their video chat AA and NA (Narcotics Anonymous) meetings. Twenty-four hours a day, seven days a week, addicts who need help can log on and find someone to talk to for free. The site’s been a big help for my father and his friends who can’t afford rehab or medical services. The site isn’t a cure or a replacement for more comprehensive recovery methods, but it can help when there’s no other option.

Participate in clinical trials. If you’ve got some time—anywhere from an hour to two weeks—and you’re not queasy about needles, sign up for a clinical trial. You can get a checkup from professionals for free—sometimes they even pay you. Before each test begins, the subjects must be checked by doctors for any outlier medical conditions. When I didn’t have health insurance, I would peruse ClinicalTrials.gov like it was a Craigslist for health care. (I’d recommend not actually using Craigslist.) I’d stay away from anything too intense. Usually I ended up chickening out and just giving blood because I always feared I’d end up with fish gills on my neck and radioactive genitalia. This never happened to Robert Wohner, who wrote about how he spent two weeks at a clinical trial and made $2,000 for his trouble. Wohner was diagnosed and treated, for free, for high cholesterol and sleep apnea. (He also tested falsely positive for pericarditis, a common misdiagnosis in young African-American men, so it’s not a foolproof strategy.)

To find a clinical trial, go to the CT site, type in your city, the word 'AND' in all capital letters, and something you’d like to help with testing for, and the site will pull up all the trials that are actively recruiting. Scroll through, read the description (and the fine print) and email the doctors to sign up.

Take advantage of Planned Parenthood or a free clinic in your area. If you are lucky enough to live in an area where you have access to Planned Parenthood or a similar clinic, it can be a godsend for people without health insurance. They offer sliding scale services.

Of course, going on birth control (the main reason I visited PP) can be pricey. My pill, Ortho-tri Cyclen Lo, costs $110 a pack without insurance. With insurance, it was only around $15. While I was without insurance, I went a full year without birth control pills, which I’d been prescribed at age 14 for severe cramps. This meant a year of feeling just lovely once a month, because I didn’t have a spare $110 for the pills. The only health care shortcut I tried was going on a more generic, less expensive pill, but my uterus is a fickle beast and only wanted that sweet, sweet OTC-Lo. If yours is more resilient, give another lower-cost pill a try.

Being without health insurance is incredibly stressful. A week before I was once again insured, I tripped on a Brooklyn sidewalk and my ankle swelled grotesquely. An X-ray would have emptied my savings. Luckily, days of icing and elevation did the trick. Ideally, we'd all have health care we can afford. Until then, there are stopgap ways to dodge the system and get some much-needed treatment.

Photo via (cc) Flickr user 401K.