INDULGENCES health lab
by dr. joel
No HealtH INsuraNce? THere IS A SAFeTY NeT
Back in October, I went to Washington, DC to lobby Congress with the Gay and pitals and clinics will help you apply for services when you arrive, in part because
Lesbian Medical Association (GLMA). I figured we’d promote the early treatment it will help them get paid for the work they do.
of HIV, anal pap smears or the health benefits of marriage equality. I was surprised In addition to the more general coverage required by the state, some counties
to discover that health care reform, with a public option, was high on GLMA’s wish have special programs for specific medical conditions, like diabetes, high blood
list. Surprised until members of our community related their tales of losing health pressure and HIV/AIDS. The California HealthCare Federation website at chcf.
insurance. For a variety of reasons, a disproportionate number of the LGBT people org, has information on all of these programs for the entire state, including which
fall through the cracks of the employer-based system. 19-year-olds may come clinics and hospitals participate. In some cases, these clinics are less expensive
out to their parents, get thrown out of the house and off their parent’s insurance. options even if you don’t qualify for specific programs.
Some employers don’t grant health benefits to their employee’s same-sex part- Some problems can’t wait for paperwork and a clinic visit. If you have an emer-
ners, who may be home parenting. Transgender individuals may be denied some gency, you don’t need to worry about insurance. Federal Law requires almost any
or all coverage because of their gender identity. The list goes on and on. emergency room or hospital to treat you until you are stabilized, regardless of
Given the current levels of unemployment, even more people are going medical insurance or legal status. It does not, however, prevent them from giving
without health insurance at this time. At The Rage Monthly, we want to give you a you a bill later. In the long run, it’s usually cheaper to head things off with a clinic
look at some of the programs available to Californians without health insurance. visit for non-emergent problems.
California requires all 58 counties to provide a safety net for adults without health If you can afford a doctor, but not prescriptions, some of the pharmaceutical
insurance, but gives them wide latitude in how they do so. San Francisco, has a companies can help. Most have a program to give discounted medications to
specific hospital for the uninsured, a network of city clinics and a city health plan. people who make too much for “indigent” care programs, but not enough for
San Diego, Los Angeles, and Orange Counties use a network of private and com- medications. It’s usually a narrow income range, but it’s worth looking into, usu-
munity organizations to provide care to the poor or uninsured. ally with your doctor’s help. If that doesn’t work, don’t forget to ask your doctor
Most California counties base eligibility on income as compared to the Federal about samples. They’re not as plentiful as they used to be, but they’re still out
Poverty Level (FPL), which is $10,830 for a single person, and $22,050 for a family there. Comparison shopping can also help. Many large chain pharmacies have
of four. San Diego’s program is called County Medical Services (CMS) and covers a list of medications deeply discounted (Wal-Mart fills certain prescriptions for
eligible adults 21-65 years old, who earn 350% of the Federal Poverty Level (FPL) $4. per month). Some medications can reasonably substitute for each other, so
or less. Orange County’s programs begin at 200% of FPL or less, while L.A. County asking your doctor for alternatives and shopping around may save you money on
has multiple programs, some of which are not based on FPL. prescriptions. And while I don’t recommend it for a variety of reasons, some of my
The programs can require a lot of paperwork and some have “co-payments” or patients get their medications across the border.
“shared cost.” Some pay for past treatment and some do not. Notably, L.A. County One thing that doesn’t need to stop, even if your insurance does, is vigilance
has some programs that cover undocumented immigrants, while San Diego and about HIV testing. Many sites, including the Departments of Public Health and
Orange County don’t. If you think you may be eligible for aid, most counties have local LGBT Centers offer free HIV testing. You can also cut costs by staying healthy
a website (through their Department of Public Health) or a toll free number for with exercise, a balanced diet, safe sex and limiting alcohol and tobacco use. Have
eligibility information. For urgent medical problems, most county approved hos- a great and healthy 2010!
48 RAGE monthly | February 2010
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