I am 24 years old and do not have insurance. I am scheduled for a vitreoctomy on December 13th of this year. They will not perform the surgery without insurance. The state insurance in my state has a six month waiting period on pre-existing conditions. I am not eligible for Medicaid or COBRA. Because I don’t have any children, I am not eligible for BadgerCare. All insurance companies have denied individual coverage due to my diabetes. I can pick up insurance through work in three months, but I cannot put off the surgery any longer or I will lose my sight in my right eye permanently. What should I do?

If you are scheduled for a vitrectomy, you must have been evaluated by a vitreo-retinal surgeon already, which means he/she knows the medical necessity. I was in a similar predicament in 1985 – without insurance and requiring immediate and expensive treatment to save my vision. I courteously explained my situation to the specialist and he agreed to let me make monthly installment payments, which I did for the next three years. If you don’t have family or close friends to turn to for financial assistance, I would suggest that you take this approach with your doctor. If he/she isn’t willing to do this, check with other retinal specialists in your area who may be. Another option is to check with your state’s optometric or ophthalmologic associations. Also, there is a National eye care program for low-income working Americans called VISION USA; it provides free eye examinations and eyeglasses, not surgical services, but you might be able to get a referral to an affiliated retinal surgeon. Lastly, you could contact your state’s chapter of the American Diabetes Association and ask them to advocate for you.

PC
Additional comments from David S. Holtzman, Esq.:

I have three suggestions, one of which is extreme:

Contact your local chapter of the Lion’s Club. They have a long tradition of supporting the saving of eyesight.

Second, contact the surgeon and hospital to see if there is any possibility of providing the service as charity care, assuming you have few assets (you do not own a home, have no great amount of savings, stocks/bonds, don’t own an expensive car).

The last option is to have the service performed and declare bankruptcy when the bills come in. Prior to taking this option, you should consult an attorney in your area who is familiar with laws surrounding bankruptcy.

DSH