4 types of patients who may not be able to pay their bills

1. The uninsured: These are simply patients with no insurance. Most of them are the working poor who make too much to be eligible for Medicaid or other entitlement programs but who have no insurance. According to the U.S. Census Bureau, 45 million Americans had no health insurance during calendar year 2003, an increase of 1.4 million over 2002. However, some of these patients may be employed with large incomes and a wealth of assets. The Census Bureau found that 11.2% of uninsured people have family income of $50,000 or more, and 7.1% make $75,000 or more.

2. The underinsured: These are patients with low-paying jobs, high deductibles, and high copays. Their insurance pays for part of their care, but they don’t have the money to pay for their share.

3. Indigent patients: These patients are either unemployed or work part time at poorly paying jobs. They have few assets and little, if any, income. Many of them may be eligible for Medicare or other programs but may not know it or may not know how to apply.

4. Undocumented workers: Patients without a green card pose a significant problem for hospitals. These patients often can qualify for emergency Medicaid assistance for acute care but don’t have funds for long-term or follow-up care. They show up in the emergency departments only when they’re very sick or seriously injured and may give false names or addresses because they don’t want to be deported.