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Health Insurancce For Self-employed Mainers by Susan Whitaker
If you’re one of the 135,000 plus Mainers without health insurance coverage, you know that you’re paying top dollar for health care. Here’s why: Insurances negotiate a reasonable and customary fee schedule for doctors and hospitals, which limit the final costs to you through your insurance company. However, if you are paying all your bills yourself you get no write off. Also, your claims are not run through a claim system, which may pick up costly billing errors. In other words, you pay the highest amount with the most billing errors.
One way to avoid paying for errors is to scrutinize and question your statements. Another way to save costs in general is to participate in sliding scale or no cost medical clinics and we have some very good options in our area. Even if you net income is high, some of these services are available at a lower cost than private health offices. Ellsworth Free Medical Clinic 248 State Street (inside the Mill Mall – 2nd door on left) Ellsworth, ME 04605 Phone: 667-7953 Staffed by retired doctor Marshall Smith, this free clinic hosts 30 to 40 patients in a busy week. They welcome people of all ages from all areas that have minimal or no health insurance coverage. They do physical exams if you’re well and manage problems if you’re not. The office assistant, Elaine, said that the wait for non-urgent problems is usually less than two weeks and the only fee is a request to drop a donation into the piggy bank. The clinic also performs some free lab work. Family Planning – Downeast Health Services The listings below cover the clinics operated by Downeast Health Services, but Family Planning Clinics exist throughout Maine. Check the website or phone directory for the clinic nearest you. Ellsworth, 52 Christian Ridge Rd. 667-5304 or 800 492-5550 Machias, 71 Court Street 800 492-5550 Calais, 37 Union Street 454-3634 or 800 924-2628 Family Planning offices handle all aspects of women’s health. You pay according to how much you make, though no one is turned away for inability to pay. They accept all insurances including Mainecare and the Maine Breast & Cervical Health Program (more later on that). Feel free to call them for a quote on cost of services. Family Planning provides an-nual exams, pap smears, low cost contraception such as birth control pills and Depo injections, and sexually transmitted disease screenings. They also provide care for gynecologic problems. Men are treated at the clinic, too, for sexually transmitted disease screening and problems. The Ellsworth Clinic is open on Wednesday evenings. Maine Breast & Cervical Health Program This is a proactive government program funded by the CDC (Centers for Disease Control) and the state of Maine. Its goal is to diagnose breast and cervical cancer early, when survival chances are best. Therefore, it focuses on the highest risk group for this disease; women 50 years and older who are uninsured or underinsured and whose incomes are at or below 250% of the federal poverty level, which computes to $33,000 for a family of two, and $50,000 for four. The MBCHP pays for an annual physical, which includes; breast and pelvic exam, pap test, and mammogram. A site contracted with the program must provide services, but there are lots of them. Call 1-800-350-5180 to see if you qualify and find a site near you. TYY 1-800-438-5514. Maine Coast Community Dental Clinic Downeast Health Services 190 Beechland Road, Ellsworth 667-0293 Dr. Mark Boyd, the clinic’s full time dentist, and Dr. Mark Horowitz work with two dental hygienists to provide dental cleaning, x-rays, fillings and root canals. New patients are accepted by appointment and services are rendered on a sliding fee scale. They accept Mainecare, too. Clinic hours are Tuesday through Saturday. Patients of all ages from all areas are accepted. Good dental health enhances overall health, so join the over 350 people each month that receive affordable dental care. In addition to a small grant from the state, this valuable service survives on its sliding fees and welcomes donations from those able to offer them. For The Whole Family Local Hospitals And Health Centers If you need local hospital and health care services call the business office for information on any sliding fee or free care programs they may have. Sliding Fee Health Clinics (some with Dental services). This listing comes from Consumers for Affordable Health Care. Their website contains the complete list of clinics in all Maine counties. Hancock County • Bucksport Regional Health Center; 469-7371 Washington County • Arnold Memorial Medical Center; 497-5614 • Harrington Family Health Center; 483-4502 • Eastport HealthCare; 853-6001 • Regional Medical Center, Lubec; 733-5541 • East Grand Health Center, Danforth; 448-2347 • St. Croix Regional Family Health Center, Princeton; 796-5503 • Whiting Bay Family Medicine; 733-2900 Even though huge health care challenges face the self-employed Mainer today, we must preserve this way of life. Those who work the sea, fields or woodlands of Maine are major contributors to our unique culture and economy. It is the measure of good government when hard working people not only survive, but thrive. The above offerings are some attempts to support the self-employed Mainer. Use them with pride. Susan Whittaker is a certified professional medical coder and is currently the Coding Specialist for the Health Centers of MDI Hospital in Bar Harbor. She offers private consultations to physician practices and individuals. Reach her at codermd@netzero.com. |
