FINANCIAL ASSISTANCE FOR MEDICAL BILLS
In the United States, there are for-profit hospitals and non-profit hospitals. Most hospitals in the US are non-profit hospitals. This means they are not allowed to make profits in the same manner that a business would. Hospitals often charge insurance companies lower medical rates than they charge the general public. This results in the public paying higher medical costs than the insurance companies.
The Affordable Care Act (ACA), enacted March 23, 2010, added new requirements that hospital organizations must satisfy in order to keep their nonprofit status. These new requirements continue the IRS focus on the activities and policies of tax-exempt hospitals and the implication that tax-exempt hospitals must be required to “justify” their tax-exempt status, especially with regard to serving patients unable to pay for the costs of their medical care. IRS Rule 501(r) that takes effect as early as January 1, 2016 not only adds specific requirements for hospitals to qualify for tax-exempt status, it adds restrictions for how they can pursue payment for care provided. Specifically, section 501(r) states that individuals must be charged the same rate or less than the insurance industry. To charge people more then insurance is engaging in profit making. The amounts billed to patients without insurance must not exceed the amounts generally billed to individuals who have insurance or less for specific services. The most an individual can be charged is no more than the hospitals HMO would be charged.
The 501(r) rules primarily govern how hospitals can bill patients for medically necessitated emergency care and has four main components:
• 501(r)(3) – Establishes the requirement to conduct a Community Health Needs Assessment (CHNA)
• 501(r)(4) – Governs financial assistance policies (FAP)
• 501(r)(5) – Sets limits on charges and defines average general billing (AGB) and methodologies for calculating the limitations
• 501(r)(6) – Sets communication requirements, timetables and restrictions for billing and collections.
Hospital organizations must comply with all four components to qualify for tax-exempt status.
Parents For Care
Parents for Care is an organization for care givers of the seriously mentally ill. It offers support, friendship, and education to the families of those suffering serious psychiatric disorders such as schizophrenia, bipolar disorder, major depression or depressive disorders, and PTSD. GoFundMe is used to award small grants to families struggling to stay afloat financially while dealing with the demands of care giving. Every penny of every donation goes toward families of those with serious mental illnesses in the form of small grants and products to help those who find themselves in financial straits while caring for a loved one with mental illness. Parents For Care’s popular monthly support meeting for care givers is accessible both in person and via Skype, with educational topics and a chance to meet other care givers who can support you in the demands you face assisting your family.
The Partnership for Prescription Assistance can help qualifying patients without prescription drug coverage get the medicines they need through the program that is right for them. Many will get their medications free or nearly free. For more information, visit http://www.pparx.org/ or call 1-888-477-2669.
Blink Health: Blink Health is the new way for all Americans to save on their prescriptions. Everyone now has access to one, low negotiated price on over 15,000 medications including most mental health prescriptions. Simply pay online before you pick up at your pharmacy to save up to 95%. Having insurance doesn’t mean you pay the lowest price. When the Blink Price beats your copay, pay with Blink Health instead. If you have multiple prescriptions, you can use Blink to pay for some, or all of them at your pharmacy. With Blink, even if you’re uninsured, you pay one low price online and pick up at any pharmacy. New users enjoy $5.00 off at checkout!
At GoodRx.com, you can search by drug name to find the lowest prices at pharmacies in your area, plus find coupons.
NeedyMeds.org is a national nonprofit organization that offers free information on programs that help people who can’t afford their medications (or other health-care costs).
The comprehensive database at RxAssist.org lists patient assistance programs set up by drug companies for those who have trouble affording their medications.
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