r/HealthInsurance • u/Low_Philosopher9592 • Mar 23 '25
Dental/Vision My brother is uninsured and just got hurt badly. His life (and face) is ruined. Are there any options?
I’m sure everyone’s gonna tell me he’s shit out of luck but my brains in denial and foolishly hoping there’s some Hail Mary option to alleviate? He was just told the bill for the dental work he needs immediately is going to be $40,000. That doesn’t account for the ER trip, a shit ton of stitches and facial plastic surgery he’ll surely need for medical reasons… I know this is just reality for so many people, he’s not a new sob story but I’m gutted. He’s 24, he landed his first big boy job that he worked so hard to get TWO days ago. He struggles to make rent as is.
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u/AdIndependent7728 Mar 23 '25
Did it happen at work? Did it occur at someone else’s property? Workman comp or homeowner insurance may cover it depending on where it occurred. Is he eligible for Medicaid (what state are you in?)
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u/Teripid Mar 23 '25
Yep, it seems somewhat morbid but the first question after that initial emergency care should be if anyone else is liable.
Also uninsured health insurance doesn't mean uninsured period. Auto accidents can have medical coverage and the like.
0 details so hard to give much specific advice..
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u/buzzybody21 Mar 23 '25
He was riding a scooter and hit by another motorist, who from the sounds of it didn’t stick around at the site.
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u/sarahjustme Mar 23 '25
The hospital social worker should have more information than you're going to get here. Theres are so so so many variables.
The first step would be figuring out if he can qualify for medicaid. It can be retroactive.
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u/Adventurous-Menu-206 Mar 24 '25
My sons Medicaid was not retroactive
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u/sarahjustme Mar 24 '25
I was a case manager for medicaid, it can be. I don't make the eligibility determination, but I have definitely seen it granted back to the time the person would have become eligible. Every state sets their own rules, but there are also federal guidelines, and I don't know which set of rules the retroactive eligibility falls under. It's definitely worth trying, it's the only coverage beside cobra, in some cases, that can be retroactive.
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u/Jaded-Passenger-2174 Mar 26 '25
Depends upon the state. You might get help from the hospital social worker to get him enrolled. The hosp will want to get paid -- in states that have good Medicaid, they'll help.
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u/sarahjustme Mar 26 '25
Even if theres a possibility of charity, they know whats out there. But yeah, states that didn't expand medicaid are much harder
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u/Adventurous-Menu-206 Mar 26 '25
Let me clarify, it was retroactive for two months but he had been hospitalized twice during previous three and four months.
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u/snoweey Mar 26 '25
Louisiana is up to 3 months. You have to ask for it and you can’t have payed on a bill for it to be eligible to be refilled.
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u/coronaloco Mar 24 '25
Was the scooter insured? Idk if it’s required but if he’s covered under an automobile policy of any sort then he might have uninsured coverage in the event he is hit/injured by someone who flees the scene. I was on a motorcycle and was hit by a car that left the scene and they never found them but I did get a payout via auto/motorcycle insurance
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u/EmberOnTheSea Mar 24 '25
Check his auto policy for PIP or med-pay. There may be coverage through his own auto insurance if he was struck by a vehicle.
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u/ThunderClatters Mar 24 '25
I don’t know why you were downvoted. I was hit by an uninsured driver on my bike, it was a hit and run, and my auto insurance covered my time off from work under uninsured motorist claim. Did he file a police claim?
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u/EmberOnTheSea Mar 24 '25
People not understanding how auto insurance works. I was a PIP adjuster for years. Handled hundreds of accidents like this.
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u/riley12200 Mar 24 '25
In some states PIP pays pedestrians.
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u/WayneThebaque Mar 26 '25
Yes! I know a woman who was hit while walking across the street, and her auto insurance paid her medical bills.
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u/Eorth75 Mar 24 '25
Also, if the other driver was at fault and left the scene, criminal charges are pressed, he might be also covered under a victims compensation fund.
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u/DepravedSluttery Mar 27 '25
If this is true, some states have victims of crime compensation funds to assist, but it's very state specific.
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u/ojjuiceman27 Mar 25 '25
Find that driver and sue him into oblivion. If you have to hire a private detective it would be worth it.
There are so many cameras on the road it's impossible not to have something come up.
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u/GordoElChapo Mar 26 '25
I was just hit while walking by an uninsured motorist and my lawyer told me not only does my insurance cover it I could use any blood relatives insurance that I live with. U can call ur states insurance commissioner to see if that's am option in ur state or if u have any other options
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u/NolaRN Mar 26 '25
Go back and look for cams in the area. You generally have two weeks before the DVR writes over that video
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u/rustygrl Mar 27 '25
If this is true he can make a claim against HIS OWN CAR INSURANCE. Specifically his uninsured/underinsured motorist coverage which also covers you in hit and run on a roadway even if you are not in your car.
I'm a cyclist and we all Max this coverage out on our driver's ins to cover hit and run
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u/foodguyDoodguy Mar 23 '25
If there’s no other possible entity that is responsible: Ring it up, and file for bankruptcy. He’s got time to rebuild at only 24.
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u/pantZonPHIre Mar 23 '25
Hospitals are only required to stabilize you. They’re not going to do the reconstructive surgery he needs without cash or insurance because they know people would just skip out on the bill and try to wait out collections/file bankruptcy.
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u/foodguyDoodguy Mar 24 '25
Put it on a credit card.
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u/Additional-Suspect37 Mar 24 '25
How many people do you know with a $40,000 credit card limit? Be reasonable.
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u/honest_sparrow Mar 25 '25
At 24, not many. But I'm almost 40. So probably everyone I know? I have 4 ccs, and just one alone is $42,500. I feel like companies love to give you room to rack up big interest charges.
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u/JimmyB3am5 Mar 26 '25
Dude my Amex card has a $50,000 limit. My Capone card has $25,000. It's not that unusual to have high limit credit cards if you don't have absolutely shit credit.
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u/Additional-Suspect37 Mar 26 '25
So ... are you 24 or younger? If not, the point remains.
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u/joshualightsaber Mar 27 '25
24 and opened credit cards twice a year since 18. Not rich. 300k combined credit limit plus a card with no official limit.
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u/foodguyDoodguy Mar 25 '25
You’re right, I wasn’t thinking that thru. I was just so fking angry that this poor guy, and many ppl in this country end up in this situation all too often: Either a GoFundMe or personal bankruptcy. I was just thinking; “stick some big corporation with the bill”.
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u/someguy984 Mar 23 '25
CO has Medicaid expansion, he should qualify if monthly income is under $1,800 a month. Medicaid can be retro 90 days.
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u/IAmStillAliveStill Mar 23 '25
And that likely includes if his income is expected to be under $1,800 in the current month, even if he would expect to receive more income the following month.
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u/bbadger29 Mar 23 '25
How did the accident happen? Any auto or workers comp coverage? Or someone else’s negligence?
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u/Glitterydice Mar 23 '25
You want to apply for retroactive Medicaid immediately if it exists in your state.
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Mar 23 '25
[removed] — view removed comment
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u/skydreamer303 Mar 23 '25
Low cost dental care after major trauma is a mistake imo. You want highly skilled dental professionals doing it especially as it sounds like he's a reconstruction case.
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u/lollykopter Mar 23 '25
There are 3 things I don’t want a discount on: tattoos, dental work, and a lawyer.
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u/ajoyce76 Mar 23 '25
I have never understood discount tattoos. Nobody NEEDS a tattoo and you're going to have it for life. Why skimp?
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u/Objective-Amount1379 Mar 23 '25
You can get great care at a dental school. The downside is time- it will take much longer and probably be less comfortable than going to a nice dental office that offers sedation, etc but I would consider it. Or go to Mexico- but that's not feasible for everyone
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u/Quincy-Swirls Mar 24 '25
Having treatment done in a dental school is completely fine. Everything the student does is closely monitored and sometimes even partially done by licensed dental professionals. In some ways it’s even better because every action is scrutinized to perfection because the dental school needs to be able to keep their accreditation. The only downside is that procedures take a very very long time due to all the checks the instructors have to make and treatment will take many appointments to complete.
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u/ThunderClatters Mar 24 '25
Sounds like he needs to see an oral & maxillofacial surgeon first if he has facial trauma and fractures.
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u/Quincy-Swirls Mar 24 '25
This still applies because that program is available for students wanting to go into that specialty. They would still see a licensed oral & maxillofacial surgeon for diagnosis, checks, etc. but be treated by the students at a reduced cost which is what is important to the patient due to their financial situation.
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u/SadNectarine12 Mar 23 '25
Facial trauma/reconstruction dental is outside of the scope of dental students, even in specialty programs. Depending on the injuries, it’s usually done in stages, in tandem with plastic surgery.
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u/climbing_butterfly Mar 23 '25
A dental school will not handle this
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u/Embarrassed_Riser Mar 23 '25
No he would need to find an ORAL SURGEON MEDICAL SCHOOL, they may handle it.
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u/Bullsette Mar 24 '25
Where are such schools located?
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u/Low_Philosopher9592 Mar 23 '25
He’s in CO. He hasn’t actually started his new job yet, hasn’t even got to the paperwork part so no coverage there. The accident itself is tough. He was on one of those city scooters and a car screamed through an intersection without stopping. No contact but the dodge was what got him. There are definitely cameras that caught it and he has 2 friends to confirm the incident was fucked. The problem is his BAC was just barely above the .08, which also applies to scooter riders.
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u/Any_Water9245 Mar 23 '25
Unfortunately I’ve been injured on one of those at the fault of dodging someone in San Antonio and was on the hook for everything. (Tore ACL etc.) I had also had a couple drinks never had my BAC taken at the hospital but. Yeah it’s unfortunate he’s going to be responsible … even my MRI to determine my torn acl (I couldn’t even walk or weight bear) I couldn’t get without paying up front since I was uninsured at the time. Hopefully he has a lot of generous people in his life who would support some sort of crowd fundraising.
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u/Inevitable_Road_7636 Mar 23 '25
Wait, he is uninsured AND unemployed at the time of the incident, AND lives in Colorado, but will have insurance soon through a employer?
Ok, here is an idea to explore.
Reach out to the hospital for a social worker, Colorado is a medicaid expansion state so he might have something there. At the very least if he had no income on the month of the incident and wasn't employed (meaning no other coverage) he might qualify for medicaid to cover the ER visit which will help there.
Now, in terms of the other work, how long till his new employer insurance kicks in? Cause he could use that to cover the care for what he needs in terms of reconstructive surgery. Hopefully it isn't long, cause he basically just needs to get to the sign up portal on day 1 and select his care, should take a few days to register and get virtual ID cards, then find doctors and get going.
Basically if he moves correctly, I am thinking he should be able to "stitch" together medicaid and his employer insurer to create coverage. Remember medicaid does back coverage so even though isn't currently signed up, it will cover past incidents from 30 days ago to 3 months ago by state.
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u/SCW73 Mar 23 '25
My guess would be if he hadn't actually begun working the new job yet and he will have a decently long recovery time, he may not be able to keep the job. That's no good rent wise, but if he gets medicaid, they will likely cover medically necessary procedures.
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u/Inevitable_Road_7636 Mar 23 '25
Depends on the coverage and how bad we are talking about. Either way he will have coverage from one or both of those two, but he needs to get the ball rolling on medicaid at least right now as their is a unknown timer ticking down on that back coverage.
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u/Admirable_Height3696 Mar 23 '25 edited Mar 23 '25
Doesn't depend on the coverage. He won't have employer insurance, he hasn't started and hasn't paid his share of premium. Employer insurance is off the table. He's not able to be onboarded (did you forget he was in a serious accident?). He needs Medicaid. Stick to real world advice not fantasyland BS.
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u/Inevitable_Road_7636 Mar 23 '25 edited Mar 23 '25
Lets say it starts tomorrow, it would matter as it would then start to cover his care. Health insurance isn't like car insurance, it covers the problems right now being faced, not when the incident occurred but when the care was received. Lets say my job starts on 24th, I fall and badly mess up my arm today (grade 3 sprain), I sign up for insurance on the 24th, get the card on the 25th, and go to urgent care on the 25th (or actually with many employer policy's I could get it on the 24th as I am considered covered just haven't selected care plan).
So while the employer insurance will not cover the ER visit it will start to cover all these other things, hence why I called it "'stitch' together medicaid and his employer insurer to create coverage" cause the two should be able to cover most if not all the stuff he is facing.
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u/laurazhobson Moderator Mar 23 '25
The issue is that it is unlikely that someone who hasn't started a job will have a job given the extensive recovery that will be recovered.
If OP already had started their job the analysis could be different depending on when employer insurance started as well as laws regarding leave.
There is nothing to "stitch" together unless OP's brother is actually able to keep their position given the reality of the recovery period that is probably going to be necessary.
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u/Inevitable_Road_7636 Mar 23 '25
It depends on employer and injuries, I could break my arm right before my current job and would have started no issues or questions. Without knowing what the injuries are, its impossible to say as "$40k" of dental could be all the teeth need replacing with implants and a "scar" is tissue damage (basically person head met the steering wheel). Things that really don't matter in a office setting, and the company can onboard them for You are jumping around making assumptions about the severity of the injury's without actually knowing them. Things can "appear" bad to a lay person and not really be that bad in terms of life threatening. You would also be surprised how flexible many larger employers (F500) company's are, as they hired a person and want to onboard them asap.
So again, unless this person is going to take STD as soon as they joined, they are probably able to onboard to the company.
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u/Turkeygirl816 Mar 23 '25
Wouldn't the dental work be covered by medical insurance because it was related to an injury and not considered routine dental work?
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u/Inevitable_Road_7636 Mar 23 '25
Probably a large portion of it, but part of it will probably also go through dental insurance. This is one of these things that without the injuries known there is no way to even begin figuring out what treatments are needed, and what on going care will look like (and which insurance pays for what). Thing is, don't expect medical to cover 100% of it as they will call some of it routine, and dental will cover some as it is routine.
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u/Bullsette Mar 24 '25
How are you confident that it will cover pre-existing conditions, especially such a very expensive to fix pre-existing condition? I certainly hope that it will but I have doubts. He has not even started the new job yet let alone been accepted into their insurance pool.
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u/Inevitable_Road_7636 Mar 24 '25 edited Mar 24 '25
Go look up the ACA, and the words "pre-existing conditions"
Health insurance and auto insurance arent the same thing
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u/IAmStillAliveStill Mar 23 '25
He should still contact a personal injury attorney. Colorado is a comparative negligence state, iirc. If your brother is less responsible for the accident than the driver (and it sounds that way from what you said), then he can still recover damages. He can’t recover all of his damages, if he’s assessed to have some share of responsibility for the accident (and he almost certainly would, as he was intoxicated; but, if there’s a video, it’s possible he might manage to avoid that if a sober person wouldn’t have been able to do anything differently).
I used to be an insurance adjuster, including for Colorado. What I don’t recall off hand (because it didn’t come up for me when I was doing this work) is whether a Colorado driver who is intoxicated is automatically deemed liable for the accident (a provision that a few states have).
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u/hydraulix989 Mar 23 '25
How was his BAC known at the time of the accident? Did someone suspect him of drinking?
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u/Low_Philosopher9592 Mar 23 '25
It was measured through his blood at the hospital after the accident was explained
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Mar 23 '25 edited Mar 23 '25
[deleted]
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u/laurazhobson Moderator Mar 23 '25
It is not generally relevant for receiving medical care although there are some policies that do exclude for willful acts such as drunk driving. There was a post on the sub/redditt yesterday in which coverage was denied because drugs were involved.
However the issue of blood alcohol is relevant if OP's brother wanted to sue the person who hit them. Presumably hit and run is against the law and the police should be involved. With today's network of CCTV's and witnesses, it would seem likely that the car would be able to be found.
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u/hydraulix989 Mar 23 '25 edited Mar 23 '25
Right, there might have still been some recourse for this individual, but over-the-limit DUI means they will all but likely have to bear the consequences themselves. Not sure why this crucial fact was omitted from the original post.
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u/Critical_Stomach4432 Mar 23 '25
This should be thru the other drivers auto insurance then. Auto would be primary and health insurance is secondary for what isn’t covered.
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u/NoExcitement2218 Mar 24 '25
He needs a lawyer to figure out coverage. The scooter rental place no doubt has liability insurance.
As far as his healing journey, from somebody whose face was smashed pretty badly in a boat accident, the recovery journey is tough. Support him emotionally if you can. I had a lot of broken bones and multiple surgeries, six new front teeth. People who saw pics before any stitching or anything thought I’d never look normal. I look perfectly fine and nobody would know the difference if I didn’t tell them.
Depending where you are, if you get a lawyer and they determine recovery is possible, they can get an agreement with the various specialties that they will be paid out of any settlement.
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u/Radiant-Ad-9753 Mar 24 '25 edited May 13 '25
money rustic door abundant ripe like dolls fade meeting cats
This post was mass deleted and anonymized with Redact
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u/UnrulyEwok Mar 24 '25
As I’ve seen others mention, please see if the hospital has an assistance plan. All not for profits do and many hospitals have this designation. My daughter used the one at the major hospital system in Colorado Springs so I know it exists out there. Paid 100% of her bill. The dental might be another story unfortunately, but at least hospital care should be covered. And not just emergency services, any medical necessary visits/care. Best of luck and I hope he can get the care he needs!
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u/Useful_Lifeguard324 Mar 25 '25
I would not post that number on the internet. If they are able to find someone liable, the last thing you want is for some internet post to cause problems.
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u/rustygrl Mar 27 '25 edited Mar 27 '25
Read my other posts, please do not assume just because bac he will be responsible. If that driver ran the light there's fault. Look up the hoffmans - "the cyclist lawyer" she's amazing and I'm Colorado and does micromobility stuff too call them ASAP do not wait time is of the essence, you NEED a lawyer with expertise in car v vulnerable road users to help you navigate this not just any old lawyer or reddit
Document EVERYTHING throw nothing away, take pictures of everything, his face too, you need this evidence
You don't need 100%. Fault to be on the driver to get lots if not all of this covered by their insurance. Does your burger have car insurance? If so he can make a claim against his uninsured/underinsured coverage (yes even though he was on a scooter not driving) if they can't find the driver. You can also possibly sue the owner of the car in civil Court as well even if they pull the "we can't prove who was driving" bs and there are no criminal charges it doesn't matter there are options don't wait!
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u/Crafty_Attention_982 Mar 27 '25
This exact thing happened to me. Uninsured. No job at the time (technically same for him S he hasn’t started his new job). Work with the social worker at the hospital to get back coverage for medical.
I broke my nose, jaw in 4 places had to have it wired shut, fractured orbitals and lost 4 teeth.
Medical insurance can help cover everything including dental implants.
After implants are placed he’ll have to pay for abutments and crowns.
What was looking like >100k turned into 15k.
Also may be able to squeeze some out of auto insurance policy.
Edit: I was also in the icu for 4 days
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u/PhineasQuimby Mar 23 '25
Some big hospitals have charity programs. Look into this in your area
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u/vaguely_pagan Mar 24 '25
This. Have personally used it for medical bills and was surprised about how much money you could make and still be eligible at some hospitals.
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u/Medium_Sunbeam Mar 26 '25
It is a lot of work, but is doable if you are persistent. Ask about charity programs, ask about getting an itemized bill, ask about payment plans, and look into this organization which helps with navigating these. https://dollarfor.org/
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u/Individual-Mirror132 Mar 23 '25
Well there’s a couple avenues he can explore. If he can somehow qualify for Medicaid, they usually will cover bills a few months back, even if you didn’t have insurance at that time.
For the ER bill, depending on the hospital, he may qualify for charity care. All nonprofit hospitals must offer a charity care program to their patients per the affordable care act. They will be able to waive all or part of the cost of the service based on his income. He has 240 days to apply for it from date of service, but some states extend that (like CA allows you to apply for over 3000 days). They will then use their charity to cover the bill. For profit hospitals don’t have to participate, but many offer similar programs. Check out dollarfor.org for more help here.
For the dental work, that’s going to be hard. There’s not a lot of programs available for cosmetic/reconstructive services. But if he can qualify for Medicaid (healthcare.gov), they may cover the cost.
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u/lemon-rind Mar 26 '25
I used to do authorizations for Medicaid, but not in Colorado. A lot of reconstructive work and, sometimes, dental work are covered under the medical policy if they are considered medically necessary. Since this was due to trauma, I would think it would be covered. Most states also include dental coverage with their Medicaid policies. I can’t speak for Colorado, never worked in that state.
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u/carltondancer Mar 23 '25
Ask to talk to financial aid at the hospital. Explain to them that he doesn’t have the means to cover the ER bill. They will provide him a form for finance assistance which could cover up to 100% of the bill.
Dental - idk where you’re located but find a high quality local university with a medical or dental program. Explain the issue and they may do it very low cost for training.
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u/No_Garage2795 Mar 23 '25
If I’m catching everything right, he’s the victim of a crime. States have crime victim compensation programs and medical expense programs including emergency Medicaid coverage. Look into your state to see what needs to be done to get him covered. Also, I hope the police are pursuing finding the driver. Their insurance would be responsible for paying the medical bills. It’s a lot to take on at once, particularly when there’s a big recovery involved. You may want to consult a reputable accident attorney to make sure all of the necessary documentation is being filed.
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u/FollowtheYBRoad Mar 23 '25
I'm going to make a big assumption that the dental work is going to fall under medical--depending on what happened, such as an accident or injury, and how/where it happened. If that's the case, does he have health insurance? Was his employer health insurance in effect at the time he was injured? If so, what is the out-of-pocket maximum?
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u/thebabes2 Mar 23 '25
What type of accident, where and could it be possibly covered under some kind of insurance?
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u/Embarrassed_Riser Mar 23 '25
30 years working in the Health Insurance/Dental Insurance and the ACA field
Word to the unwise - YES you will hate paying for either a health plan or dental plan when you barely use it. But you are surely going to wish you paid for it when you need it. Why ANYONE would go without coverage is beyond my comprehension. So what's in store for your brother?
Good News first: Because of the ACA there is no longer a PRE-EXISTING clause in any insurance plan. Therefore Medical Treatment for a medically necessary procedure is covered regardless of when the insurance plan became active. In My day there were up to 6 months of waiting or very clear policy guidelines that would DENY any treatment for anything before the policy being active.
"He was just told the bill for the dental work he needs immediately is going to be $40,000."
YES, DENTAL WORK IS EXPENSIVE - I KNOW.
Take into consideration just 1 Dental Implant with a crown - $2200 x 32 teeth = $70,400.
As a reminder DENTAL WORK other than the oral surgery to extract teeth, Anesthesia, and Perhaps the Operating room Charge, and if general anesthesia is needed the Oral surgeon's fee is covered under health insurance but not the Dental.
Dental Plans often have LIMITED benefits per year - typically between $1,000 to $3,000, and may limit, as my policy does to three implants per the lifetime of the policy.
The Abmulance fee, ER fee, and ER doctor fees are covered under the Health Plan
Room, Food, Surgical, IV drips, Medications given, and Hand hospital fees are covered under the Health Plan
Oh that's right he didn't have one. So what happens?
Those fees become the responsibility of the Patient. So since there is NO INSURANCE the first thing is to wait for the bill to arrive and pay it. Or call the Billing office of the Hospital and work out a payment schedule. They may forgive a portion or a great big portion or forgive the bill altogether.
For example 2002 March, I remember it so well, 10:30 pm I incurred an injury that required 3 stitches. Drove to 5 different walk-in clinics all closed at that hour. Last resort ER, total cost $2865. I was low income at the time, had no health insurance at the time, and the Hospital forgave 100% of the bill. - late in 2020 called the hospital and donated $1000 ... to help someone else, because I could.
What to do now to begin to explore possible solutions
1: You did not mention the date of the incident
2: Do you live in a state with expanded Medicaid
3: Does his employer offer Health insurance Coverage - if yes when is the enrollment period
If he is low-income and lives in a state that offers expanded Medicaid, he may be eligible to enroll now.
In my State Medicaid is backdated up to 90 days if it is your FIRST TIME enrolling.
I know in some states like Texas - He would not be eligible for MEDICAID because he is male. From what I have read, heard, and seen in court judgments, they reserve MEDICAID for Women and Children. And even then it's limited.
OPEN ENROLLMENT for an ACA plan with the potential for Financial Assistance opens November 1, 2025 - December 15, 2025, for an effective date of January 1, 2026. I would suggest that he enroll during that time if he gains no other insurance, because at least from that time moving forward any procedure would be covered, but not the ones incurred as of today.
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u/laurazhobson Moderator Mar 23 '25
Terrible position to be in even if one had insurance.
The issue is the kind of medical care that OP will need.
As others have suggested, he most likely will be able to get Medicaid to cover the cost of his care in the hospital. Hopefully an application has been made and if not OP or his family should speak to the social worker at the hospital for help to navigate. Since Medicaid is retroactive three months back, OP's brother shouldn't have medical debt from the hospital.
The issue is the care he will need on going including dental and facial plastic surgery. I would imagine finding dentists and plastic surgeons who accept Medicaid would be difficult and those who have the skill set to reconstruct a face and a mouth probably don't take Medicaid - but again theoretically the cost would be paid by Medicaid.
Sadly I am assuming that OP will not have a job with health coverage during recovery as most employers wouldn't hold a job open for a person who hasn't started but OP or family can confirm the corporate policy tomorrow.
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u/PublicApartment635 Mar 24 '25
Did you think about gofundme page, i have seen some cases, folks raised money from friends, family
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u/SeamusMcKraaken Mar 24 '25
Sounds like he was a victim of a crime. There may be a victims compensation fund in your area. It's one of the many fees they collect as part of the court costs when you're convicted of a crime.
a former coworker was shot in the face by a passing car and was covered. A relative of mine was murdered a few years ago and this fund covered the burial. He needs to speak with the police and a victims advocate. Yesterday.
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u/Liberteez Mar 23 '25
What happened? There are avenues of recovery in some types of accidents where workmens compensation, auto insurance, home owners insurance or an umbrella policy could be on the table. If his income is low or now greatly reduced some states will allow Medicaid enrollment.
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u/No-Drop2538 Mar 23 '25
I hear Brazil is the place for good and cheap plastic surgery, maybe they do dental too. But Mexico is good dental.
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u/redditreader_aitafan Mar 23 '25
Apply for Medicaid. They can backdate coverage up to 3 months but coverage automatically goes back to the first of the month in which the person applied. Apply immediately. I highly recommend talking to the hospital social worker to help with the application.
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u/M3UF Mar 23 '25
He would have been a trauma call-most states have special funding for trauma alerts. The ER social worker should be well versed in this the hospital wants to be paid! We have a contracted service to assist families with this even in FL!
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u/2ride4ever Mar 24 '25
Ask him to think about applying at the billing office of the hospital system for the Patient Financial Assistance Program. The benefits can be backdated. It doesn't only cover the hospital but also all providers and services under the corporate umbrella. It's a great program. I didn't know it existed until we desperately needed it. It covers prescriptions written by a covered provider, filled at a covered pharmacy. An application is submitted yearly.
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u/mtngoatjoe Mar 24 '25
When you start getting bills, apply for financial aid. It's usually a pain to provide all the details they ask for, but many hospitals offer help.
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u/IncidentalApex Mar 24 '25
Wear a helmet people. I didn't always, but there was a picture on rotten.com many years ago of a motorcyclist who landed on an asphalt road and skidded to a stop using his face. It woke me up to what I was risking.
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u/Toastmaster12343 Mar 24 '25
You can apply for financial aid from the hospital as well as the other good suggestions here.
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u/Apataphobia Mar 24 '25
If he got his first big boy job two days ago, then he should be able to get insurance. If his job has insurance options but he hasn’t signed up for them yet, then he should still be able to do that. If he hasn’t actually started yet, then I’d consider contacting the manager to make sure he’s aware and talk to the manager about getting on insurance asap.
If his job does not offer insurance, he can still get insurance through the aca plans. A new job is a life change so he should be able to do that still. He should be able to get both medical and dental. Some dental plans have waiting periods btw, it’s worth in this case I think going with the more expensive options that allow major dental immediately.
I’m not sure how the plans handle expenses that occur just prior to signing up. I want to say that there is some kind of grace period, but others can probably speak more to this.
If you can’t get the initial ER expenses covered, then you should be able to negotiate with the hospital.
The only other thing that comes to mind, he’s 24 so he may be able to get coverage also under your parents plan if they have one. However, I don’t know if his qualifying event allows him to join your parents’ plan outside of open registration.
I hope others that know more will comment here on points where I may be right/wrong. Good luck.
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u/Cadillacquer Mar 25 '25
There are plastic surgeons who spend time every year traveling and helping people disfigured in other countries. Perhaps with a kind letter one could be persuaded to do a pro bono for an injured American here at home - you’d probably have to pay the surgical center and anesthesiologist and any stay at a recovery place.
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u/Client_Famous Mar 25 '25
Speak to the hospital social worker. I took a friend who desperately needed medical treatment to the county hospital and they signed him up for Medicaid while he was there, which covered his stay. It was applied retroactively.
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u/PdxPhoenixActual Mar 25 '25
Ask for a payment plan. See if they'll wave any/some/all of the cost... as he's gonna be unemployed & unable to make any payments for awhile... ?
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u/Tiny_Teacher5880 Mar 25 '25
Some states have emergency Medicaid available for circumstances like this. Check w the hospitals financial assistance dept.
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u/grisisita_06 Mar 25 '25
i need 75k in dental work due to acid reflux and it’s not covered. no idea what to do so far but things are failing fast. worst part is because my insurance dragged out me having surgery for a few years and covid
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u/Select-Sherbert-165 Mar 25 '25
If he can’t get insurance I would honestly just book a trip to Mexico and get treated there. The whole trip would probably be a fraction of the $40k you quoted. Go to a border city. They often times cater to US folks so it should be quiet easy to book an appointment from the US. Beware though that even established businesses/offices use WhatsApp to communicate so do your due diligence when it comes to researching and choosing where to go if you go this route.
Besides, here in the US your brother will have to jump through hoops and get referred to so and so and do all that convoluted crap to get treated. A private doctor in mexico will schedule and send him where he needs to go without all the hassles.
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Mar 25 '25
Emergency Medicaid/charity from hospital. Bankruptcy at 24 is not impossible to come back from. There are options, try to get a social worker from the hospital to guide you
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u/Embarrassed_Crab7597 Mar 25 '25
Sounds like he’s fairly new to living the adult life. I would contact his HR and see if there are any benefits he signed up for without realizing it. Probably not but it’s a rock to turn over at least.
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u/Mandinga63 Mar 25 '25
Set up a go fund me or something like that to help raise money for his medical bills. People do this all the time.
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u/Independent_Fox8656 Mar 26 '25
He’s under 26. Any reason he wasn’t on your parents’ insurance? Any way he could get on that? Sometimes a life changing event can qualify you outside of the enrollment period.
For everything else: Apply for Medicaid ASAP if he can. Talk to the hospital about financial assistance. Talk to everyone you can about payment plans or reduced costs.
Is this going to prevent him from starting his job? How long is he going to be out for recovery?
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u/Academic_Whereas_329 Mar 26 '25
some plastic surgeons do pro bono work but in exchange they will likely ask to document this on social media. Reach out to every plastic surgeon is every state you can think of. Social media has a certain top 50-100 surgeons that are popular.
option b is tell the hospital he can’t pay it and they can reduce the bill for those who are poor and have proof , take the reduction than go to Mexico for the surgery and dental work, will cost you much less.
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u/8FaarQFx Mar 26 '25
County general hospital is probably his best bet on getting anything done. When my buddy without healthcare insurance got hit on a motorcycle, the local hospital just kept him alive and wouldn't discharge him until his father signed that he would pay the charges up to that point. We transported my friend immediately to county. Overall slower service, longer wait times, but they took care of him (surgery, physical therapy, etc).
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u/Hit_Refresh_Banana Mar 26 '25
Go to another country. Turkey or something. Paying cash there will be extremely cheaper. Aka medical tourism.
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u/chrisfs Mar 26 '25
Where does he live? Some places have free clinics and or low cost medical clinics, but without knowing where you live it's hard to answer that question.
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u/PlayerChaser Mar 26 '25
Check if the hospital has financial assistance, they will write it off if his w2 or income documents show less than a certain threshold. I got bit by a stray cat last year and the bill from getting the rabies vaccine was 25k. Applied and got financial assistance and it was fully written off.
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u/TinyNerd86 Mar 26 '25
Hey I know this is a few days old now but if no one mentioned Donated Dental Services this might help. (PS: difficulty eating due to missing/broken teeth makes replacement medically necessary for proper nutrition. I used to work in dentistry and we did many of these cases.) Good luck!
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u/Last_Watercress3771 Mar 26 '25
If he has auto insurance coverage, you can file a claim to determine if there is coverage. He was a pedestrian so it’s possible they may cover medical bills.
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Mar 26 '25
Ask for an itemized bill. Negotiate, ask for financial assistance. Most hospitals have one unless ur for profit
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u/nunpizza Mar 27 '25
i don’t have anything helpful to add that hasn’t already been said multiple times. but i do want to say that i am praying for your brother and whole family. i hope everything works out okay. hugs!
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u/yottabit42 Mar 27 '25
So glad the Regressive Party sued to make the ACA mandate illegal. /s
Now we all get to pay more to cover his responsibility. Yay!
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u/rustygrl Mar 27 '25
Hire a lawyer that specializes in pedestrian/micromobility /bicycle v car collisions. In CA bike law is one such firm, in Colorado there's "the cyclist lawyer" you need to document EVERYTHING NOW my partner is an expert in this area. He is the guy the lawyer hires to do all the engineering to determine fault/what actually happened.
Did he file a police report? Do that ASAP if there isn't one! There will be traffic cameras but you have to hire the lawyer and they'll get the cops on getting the footage asap! Time is off the essence before the files are lost/over written
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u/Relevant-Current-870 Mar 27 '25
Speak to hospital social worker and see if he qualifies for any charities. My oldest was a preemie and was in NICU for long time the bill was just astronomical. The social worker showed me the bill and then contacted two different charities he qualified for and between them and state insurance it was covered completely. So definitely see if he qualifies for any the hospital social worker should be able to find out for him and help hopefully alleviate some of that for him.
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u/Critical_Network5793 Mar 27 '25
if he's still in the ER , has no insurance , no money etc they may likely be able to write off the ER/medical stuff . they will try to set up payment etc but he may luck out and get a write off
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u/Lessaleeann Mar 23 '25
Apply for "charity care" at a hospital (especially a Catholic hospital) being sure to use those specific words. They have to provide a certain amount of it but try to avoid doing so if you don't use their "magic" words. Keep insisting. Also, get health insurance through the ACA/Obamacare NOW. They can't exclude his injuries as preexisting conditions. If he's very low income, his state provides it, and he can't get an aca policy for some reason, apply for Medicaid. An important thing to know: if he gets a payout for his injuries from someone else, Medicaid will require him to use it to pay them back and he could be left with nothing. He won't be required to pay anyone back if he gets a health insurance policy through the Affordable Care Act/Obamacare. Also, if this is potentially someone else's fault, never talk to the other party yourself, always get a lawyer and let them negotiate a settlement. You'll get much, much more money. You won't have to pay the lawyer anything if you lose. They'll take a third of the settlement if you win. Good luck!
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u/ariavi Mar 23 '25
Did he start the job yet? Do they provide health insurance?
What state does he live in?
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u/N2trvl Mar 23 '25
If the driver really maybe at fault contact an attorney. Long shot but might payoff
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Mar 23 '25
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