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Life was going on as usual with me working part time and shopping, cooking, cleaning for my elder parents with whom I live with my pup. I've mentioned prior it all caught up with me the end of September, when I felt a loss of strength and just not well; I was ultimately taken by rescue squad to the local hospital affiliated with our Cleveland Clinic. There they apparently determined I had an aortic dissection, which is often fatal. They put me on a helicopter for the 13 mile or so trip to the main campus where surgery was done at a cost of $47K. I had no idea and no ability to dispute any of it, but how can someone if you have the desire to live? I am nearly in tears as I write this having just returned from the post office to find bills from everyone. I have not rushed to even attempt to pay any as I spotted something on one ages ago that seemed inaccurate. My request for a copy of my record so I could go through and compile a list of other errors resulted in my getting a bill for $150 or so just to get it (copying costs). Others have said since the decision was not mine, the hospital would have to pick up the copter charges or the insurance should. But still that has not happened. I have learned these surprise helicopter bills have hurt many. It's rough enough to have a traumatic illness surprise, but then the surprise of surviving to be in huge debt...is unbearable. I don't know which way to turn. If I made payments they would be minimal. I also have added to the grand debt total some credit card debt and residual hospital bills from a prior few days I was in, back in August. Someone suggested applying for Medicaid, but I don't think it would cover charges that had taken place prior to the Medicaid being approve IF it even would be....It seems insurmountable.

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This happened to my dad in 2012.

He contacted the providers and explained that he had no money, was happy to make minimum payments but could they help him with the dollar amount. It was close to a million dollars for all of his medical and heli transport.

They were happy to help him and he ended up with 7k worth of bills that he had to pay.

Insurance never pays for heli transport and we never know this until we get astronomical bills.

It is pretty inexpensive to purchase this insurance and I recommend that everyone pay the 150 bucks annually to ensure that they don't go bankrupt from the costs.

Good luck getting them to work with you. If not, file medical bankruptcy.
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AlvaDeer Jan 2021
I was never aware that there was insurance for medical transport. I appreciate that information. I know two people who were bankrupted by this. One because a child needed transport, and another who fell into a firepit. Lives were saved; the debt was awful. If you have any direct knowledge of which companies have these policies I sure would love to know, RealyReal.
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I am so sorry. This is a very common occurrence in this country. You can negotiate the bills with the providers and work out payment plans. And you probably know this but don’t pay anything until after you’ve received the corresponding explanation of benefits from your insurance company.
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gdaughter Jan 2021
I have waited and it seems like every statement is different or I see things I question. You start to wonder and doubt yourself wondering if you WERE under the influence of pain meds or something even though for instance at this moment I would swear I never saw the actual surgeon in my hospital room. In fact to this day, no one has ever explained what happened. I do have to take partial responsibility for that as I was so angry at how they took it upon themselves to set up follow up appts without my knowledge or consent, I cancelled them as they did. Sticking me on for the day before Thanksgiving! Not to worry, I rescheduled one.
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I am so very sorry for this. The new bills just passed (the one with the stimulus) has provisions to help Americans. One is with the coverage of copter and other medical air transport; the other part is that when you are treated at a hospital out of your own insurance coverage the hospitals have to negotiate the bills. So a Kaiser patient treated at Sutter will still get the coverage. That won't help you, however. Most of the bankruptcy I see is medical bankruptcy. Wait until all bills are in, and then just do it. All bills are wiped out at once. You won't get credit for a while; that can sometimes be a positive thing. Most who have these often congenital aneurysms don't know it; the autopsy lets families know. You are lucky to be alive; now don't let the stress of bills make you sick. So sorry you are going through this.
Medicaid won't cover you retrospectively (I think). Try to negotiate the bills down. Do you currently have insurance? You need to have. You have time. Don't rush yourself.
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gdaughter Jan 2021
I did discover last night an interesting tidbit in a bill yet to pass that would keep medical debt off a credit report for at least a year and other consumer protections to protect one's credit rating. I only made it due to a late start to the copter company and the surgeon's office today and will connect with others tomorrow I hope. I am using my stimulus to help me get my POA's and other legal stuff in order. Due to my sibling's shocking attitude and comments I have much to consider. I am familiar with the big B as I called it and recuperation from it is possible. This was NOT a congenital anerurysm as far as I know. The stress from bills can make you sick and then they are scheduling follow-ups like with CT scans with contrast which I strongly object to, that will only add to it. Yes, thank god have insurance....not teh best policy but at least it is something. For somethings we wind up owing 20%. Scariest thing is that this should be my last year of work with retirement in view...30 years of service in as of July and turning 65 in Nov.
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Check with the Hospital and see if they have Charity help. My grandson had a 6k deductable and they paid about 4k since Gson had paid 2k of it because he wasn't aware of the Charity thing.

Never heard of a Hospital picking up a helicopter bill. Your usually billed for every stinking thing.
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gdaughter Jan 2021
They do have some plans based on income; insurance covered some, but not all. In fact I bit the bullet and today called the copter company who reported that I indeed have a 0 balance as the insurance picked up the charges. Sadly this is the sort of thing I realize is what raises all of our premiums. But this was the biggest bill and at least that burden is off me. I could have cried and told the rep I just wanted to reach through the phone and hug her.
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So glad to hear that at least the helicopter bill is being paid in full by insurance. Yay! Hoping for more good news for you as you untangle this.
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gdaughter Jan 2021
thank you so much!
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Check to see if your states Medicaid will back pay any bills. In Ohio some prior bills can be covered.
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There has recently been a lot of press on the subject that is called "surprise billing." It is defined as "being presented with a bill for care that you received as part of a progression of events deemed necessary by your caregiver (likely during an ER visit in which you may be distraught enough with worry that you just go with what is ordered by the ER physician, who may or may not know what your insurance covers and is not really concerned with anything other than your health and the emergency at hand).

So, what happens is the patient unquestioningly complies with whatever he or she is told as they are justifiably single minded with worry, and the physician, equally single minded as they just want to diagnose in the most expedient way what the cause of the ER visit is so as to be able to stabilize the patient and stop any immediately life threatening medical issue. In so doing, often the ER physician, out of necessity in order to have the ability to make an accurate diagnosis, orders some procedure, such as blood to be drawn or an x-ray to be taken, which may be done by a specialist (a phlebotomist, and a radiologic technologist and a radiologist, in this example) who is not in your insurance providers "network." They are classified, within your insurance documents, as an "out-of-network service provider." Subsequently, since your insurance company has no contract with them, if the service provider (the phlebotomist, the radiologic technologist and the radiologist) wants to be paid for his service he must bill you himself and said bill is not your insurances responsibility, as they state in the contract you made with them when you signed on to their plan.

SURPRISE!!! You now may personally owe thousands, or tens of thousands, or hundreds of thousands of dollars to entities who did not mention they were out of network and would be billing you separately, but rather just followed Dr's orders, much like you did.

This practice is generally not predatory in nature, but rather just not something most medical professionals think about, and since you justifiably, but still your responsibility from a legal standpoint, did not take measures either prior to any procedures you underwent or in the heat of the moment did not think to ensure everything that you let happen while in the midst of your frantic and blindly worried hospital visit was covered by your insurance, it commonly is a practice the financial responsibility of falls through the cracks, until that surprise bill presents itself in your mailbox.

That is the former state of surprise billing, with which patients who experience it are rightfully angry over, but do not know where to get help, the insurance companies have no in the moment control so are justifiably defensive of accusations, and the Dr's should not be presented with such a responsibility while needing speed and total concentration in a life-saving situation.

That's the bad news. But, thankfully, there is good news!

So many complained to their presiding politicians that something needs to be done about this as many were hurt financially by this unexpected debt, some even having to declare bankruptcy, some losing their houses, and there have even been some suicides as a result of these huge insurmountable bills, that the politicians got to work.

I'm not sure it is in effect but I think it either is very close or has already been implemented and the result is a change in how billing of out of network providers are to be paid and that a patient can not legally be billed for any procedure they were not told was out of network provided. Further, if memory serves, but you should verify ALL of this, the cost is to be absorbed, I believe equally, by the hospital the procedure took place in, and the patient's insurance company. Please do you're due dilligence!

Therefore gdaughter, you should determine if any of those bills came from out of network providers, and to then see what a paitent must do if presented
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gdaughter Jan 2021
THANK YOU. Was unaware of such sneakiness potential....this could be a full time job....
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Medicaid does cover many costs retro-actively which means that if you the time of your surgery fit within the allotted amount of time from when you apply they will pay.
Also, there's an old saying about not being able to get blood from a stone. Send them 25 bucks a month. That's you making an effort at payment and they can't go after you for lack of payment.
Is it correct for me to assume that you had some medical insurance at the time of your illness and surgery? If so, then report these questionable expenses they're tacking onto the bill to the insurance company. No insurance company on earth is going to pay extra and not question the entity sending or padding the bill. They will demand every bit of information about your case and the hospital, helicopter service, and anyone else will not refuse them. Then request all of it from your insurance company. They'll send it to you too. Let them do the work of getting all this for you, and they will. Also, I burnt off on a whole bunch of medical debt myself, much of it on credit cards. Once again, you can't get blood from a stone. They forgive it after seven years anyway. As for the credit cards, stop paying them. After a while (usually several months to a year later) they will then start making you offers on settling your debts with them and they will settle for pennies on the dollar. In the meantime, you will be without credit cards though. That's not too hard to fix. I'm assuming that your parents are elderly and probably have good credit, right? Get them to put you on one of their credit card accounts. Now, of course you'll be trustworthy and not run up a credit card bill on the account because you obviously love your parents otherwise you wouldn't be taking care of them. Be mindful of that credit card and your own credit in your own name will be restored in about 2 to 3 years.
I'm sure this sounds like a shady and underhanded way to operate, and it is. It's no where near the blatant ripping off and thievery the medical industry and insurance industry gets away with. This is often the only way the little guy can get by.
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gdaughter Jan 2021
Thank you, all on my to do list presuming I survive Monday's CT with contrast exam. I think me and my pup desperately need a vacation. LOL. Yes, I did have insurance and still do at the time it happened but the way policies are written now there are bigger deductibles and and bigger percentages to pay of whats not covered. I just now from past experience if you try to enter a payment plan, they TRY to make it so that it is paid off in X number of months. I am not going to stop paying off the credit cards though do intend to see about a new one to consolidate with a balance transfer. . Credit takes much longer to restore, but it can be done. I've been there/done that. That sort of thing can make it impossible to get a car should one need one. Debt settlement is a lovely concept, but the reality is you have to have a lump of cash at the ready which is why people struggle in the first place.
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Don't disqualify yourself from potential benefits by not applying. Apply and watch for the question about any unpaid medical bills...you may turn out to be eligible for retroactive coverage. Yes there is such a thing. If not, see if the hospital has a program to write off bills if your income is low, such as under 300 percent of the FPL, Federal Poverty Level. You have to take action. If none of these steps work, the creditors may try to sue to collect but you may be judgment proof (SSI) which means they can't take it for the debt. You could consult a bankruptcy attorney because medical debt is a major cause of bankruptcy. I would not file right away though...let's see if the new presidential administration will get some changes done for medical debt. Again, take action.
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gdaughter Jan 2021
Thank you for this very helpful, if not encouraging info.
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Hi all, just wanted to add a little more to the story: I spoke to the MD's nurse today and they are strongly urging the CT with contrast on Monday. In fact the MD said there would be "nothing" to talk about if I did not have it as it would indicate healing or not and bleeding or whatever...leaking....Nurse was sweet enough to offer to go through it with me....and they will do whatever they can to make it as comfortable as possible....(think embla, topical anesthetic). I also was shocked to learn that the MD told her and she shared on with me that I was very critical when I came in, and they really brought me back, i.e. resusitated me....It's all very scary to learn. I'm just hugging my pup and grateful to be here....
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Gdaughter, glad you are continuing to get the care you need going forward. Keep us updated!

Just a thought about the medical bill issue-- at some point as the specific amounts you might owe become clearer you might want to try posting your question regarding the money issue specifically on the Bogleheads Forum, in the section of the board devoted to personal finance issues:

https://www.bogleheads.org/forum/viewforum.php?f=2

BarbBrooklyn has recommended this site often, and I checked it out on her suggestion to another poster and found a lot of useful info there. There are a lot of well-informed posters there willing to troubleshoot on various financial topics.
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Gdaughter, I am praying that you get good news from the CT scan today. I would like to have you playing with your pup, going for walks when you can, and enjoying life. I always heard, “You can’t get blood from a turnip.” YOU ARE ALIVE. Praise God. Help others. Find things to do to take your mind off things that burden you. Be well and happy!
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jacobsonbob Jan 2021
“You can’t get blood from a turnip.” This is true, and it occurred to me long ago that one's health never gets "repossessed"--I've never heard of a cancerous growth, gallstones or an inflamed appendix having been re-installed in a patient.
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First of all, make SURE that all of your bills were submitted to your insurance company. (I presume that this is Medicare.)

You are responsible for ambulance or helicopter airlift charges due to medical necessity - but those can also be billed to your insurance and covered - at least for most of it.

Please don't "ignore" those bills. Making minimal payments while you "sort out" all of the charges is better than those bills going to collections for non-payment. Same with credit cards; make the minimum payment until you have the charges sorted out.

I've had times in the past where I had a lot of medical debt. I worked with the hospital billing department to make regular monthly payments on those bills. It took a while, but I eventually got them paid off.
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Good advice below but also reach out to the transport companies and hospital applying for financial aid.
I assume you are low income since you work part time.
You may have to consider applying for bankruptcy as well as medicaid.
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We have an adult son with a long and complex medical history including multiple big surgeries. Though there was excellent insurance in place for each surgery we were still left with enormous bills. For some we wrote letters explaining our situation and asked that the doctor/surgeons accept the amount that insurance paid as full payment. Most kindly did this. For the hospital I sent physical checks for $50 every month for literally years and years. They called and sent nasty letters but no one ever came after us for the balance. We were quietly told by one worker in the hospital administration that as long as we paid regularly nothing would ever happen, our credit wouldn’t be dinged, and though we’d be bothered by them, no action would be taken. It was true. And it was on our terms, far different than signing up for any payment plan designed by them or a collection firm. The mountain can be climbed!
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Talk to your insurance company. They can advocate for you - and should! If your insurance company doesn't help, then talk to a lawyer who specializes in medical/hospital law. Either your insurance company or the lawyer is probably going to give you the best legal advice on what to do in your situation. Follow their advice. It will be worth the money you spend on any consultation fees.
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Your Insurance should pay for your charges minus your deductible. As far as your % that you are responsible for, just let each person know that you can only pay $5 or $10 a month towards the bill then do it and don't worry about it but pay whatever amount every month snd keep your receipt.

Medicaid will not pay for previous bills and you can't hzve more than like $2,500 in the Bank and not make more than a certain monthly income.
Judt be sure you don't just do nothing. Pay an amount no matter how small to each one monthly.
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my2cents Jan 2021
Medicaid DOES cover medicaid bills 3 months prior to application date - if you qualify based on income and resources (like bank accts).
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In my state Medicaid can pay three months of bills from the date of application. Say, for example, you start the application process on January 15. It may not be complete but started. If you are approved for Medicaid, they will reach back to October 15 and pay all bills from then to January 15. I believe you send copies of those bills with the application. If I were you, I would start the process ASAP. This can be done through the hospital business office. I have seen some people use Go Fund Me to help cover extensive medical bills. I don't know if you have a circle of friends to help promote that kind of crowd source. That would help if Medicaid doesn't approve you or if they can't go back far enough to help you with your bills. Check with an ombudsman about how crowdsourcing might impact your application to Medicaid. Also, hospitals can renegotiate their bills with you. There is a lot to learn. Just take it one step at a time.
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The most stressful thing I ever did - and the best thing I ever did, is file bankruptcy. My situation was during the recession - and none of it was medical. One of the bills added was someone's medical bill. I have no idea who the person was, and it was not my bill. The attorney said to just let it flow through because it wasn't worth the effort to analyze and fight it.

Do bankruptcy. Go make an appointment with a bankruptcy attorney.
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Medicaid considers income and bills from 3 months prior to application date. So if you apply in January, Medicaid will look at Oct, Nov, Dec. It can't hurt to apply since you may at least be eligible for coverage for those months and get rid of those bills. For any months you get approved, you send the bill back to the provider with a copy of your medicaid approval letter and your id number. Then it's up to them to file for the medicaid payment. Keep track of providers that you notify - by mail or phone - date and who you talked to.

The rest of it will be outstanding debt until they start writing it off or sending to collection companies. It will be a while before that happens. You might contact Legal Aid where you live to see if an atty can help you navigate the debt by way of bankruptcy or other assistance. Legal Aid is free.
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gdaughter: Thank goodness that you're alive. Prayers sent.
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gdaughter

All too often those explanation of benefits come in over time and can change. Sometimes it is delays in the provider submitting bills, other times who knows. It would be good to contact the insurance company itself, with the latest bills in hand and take notes! Ask about each charge and what was covered, what was paid, what was written off. It's easy enough, sometimes, to do this with simple procedures, but in your case it would be overwhelming to try to go through it all and understand it all without help!

I recently received a bill from OT/PT for my mother (they were sent to her facility June-August, but we're not allowed in and they didn't think to give them to me.) I placed a call first, then told them I would need time to check this out. The balance due was for December 2018! All the bills they sent did not include that, so it was THEIR fault and THEIR delay, so I didn't rush to get it done. It did take me quite a while to go through, but wasn't a priority for me. Mom's insurance was great, and paid a lot, but they weren't 'preferred providers', so all their payments were sent by check to me (managed mom's care.) Thankfully I kept ALL of those statements together. When she was getting treatment, I asked them several times when we would get a bill (I was getting multiple checks/week from ins!) First time I was told we had a 0 balance. FINALLY they sent a bill and I paid what they said mom owed, back in July 2019.

It still took me several hours to reconcile it all. In the end it was a correct balance, but I included a letter with payment, letting them know that:
1) the delay was their own fault
2) they sent the bills to the WRONG place
3) they should have a much better system to manage billing.

Sending a bill a year and a half AFTER the treatment, while billing for treatment AFTER that period was received is ridiculous. They cashed the check but didn't respond. No surprise.

Anyway, it would be best to work with the insurance company, as they would have the most current payments and what you might owe. Sadly we often also get billed in full for services, if the ones used are not in your plan - WE don't have control over who gets consulted or what tests are ordered by what company, WE just get the bill! Some places also leave out the "waived" part, if they accept your ins plan. Beware of those!

If you can work with insurance and get a better idea what the total might be, then perhaps you can work with the various providers and try negotiating to reduce the totals. MAKE sure you get a letter from each one that might write off any debt and a payment plan. The last thing you need is to get this reduced, but then have collection agencies pestering you! If they start this before you complete investigation and/or negotiation, IGNORE them. Do NOT agree to anything!

I would also NOT rule out bankruptcy. See:
https://www.experian.com/blogs/ask-experian/can-you-declare-bankruptcy-on-medical-bills/#:~:text=In%20a%20bankruptcy%2C%20medical%20debt,t%20be%20eliminated%20through%20bankruptcy.

You will need legal assistance to do this. Since you say you live with your parents, you presumably don't have a house to lose or anything else of real value to lose (that excludes your pup, your parents, yourself!) Yes, it will "follow" you for some time (7 yrs?), but if you only work part time so you can care for your parents and have no real assets, it would make more sense to just do this. I don't recommend it for those who dug their own debt hole, but that isn't the case for you. There's no point in being under such a mound of debt that was out of your control. You need to focus on healing you and helping your parents!
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I just want to throw in some experience on payment plans with hospitals. If the hospital puts you on one of their own payment plans, you will be protected from collection action as long as you make the agreed-upon payments.

If you opt to make your own payments every month, a lot of times the hospital will choose not to harrass/sue you because they are getting money. Many people firmly believe that they are protected from medical collections as long as they pay something each month (even if it's only $1). I do not believe there is any such protection, but hospitals may voluntarily *choose* not to come after you if they are getting a monthly payment. If this matters in your situation, you might want to find out for sure.

My elder made this mistake - I told her to send small amounts each month on a medical bill and there would likely be no collection issues. For reasons unknown, she called them. They demanded either payment in full or a monthly payment which elder could not possibly afford. By her calling, it drew attention to her situation and they were watching her like a hawk after that.

If you make no payments and have disputed the balance as much as possible, then you can be sure you will be collected on and/or sued for the money. Some people can state hardship and get it written off. Others can't.
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If you are without health insurance, file for bankruptcy -- courts are very understanding when it comes to exorbitant medical bills. In fact, the cause of most bankruptcies is due to unpaid medical bills even WITH insurance--high deductibles going into the thousands. https://www.thebalance.com/medical-bankruptcy-statistics-4154729
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Before you go down the path of bankruptcy, contact Cleveland Clinic and ask for an application for hardship. Insurance companies negotiate down the rates. A hardship application is a tool to negotiate down the rates they are charging. It is hard to advocate for yourself. I would probably be in tears too. If you have someone that can proverbial hold your hand as you make the calls and go through the paperwork with you, enlist their help.

I am not a fan of the out going president. But no one is all bad. The silver lining is that hospitals now need to make their rates public. So it is now possible to look at the rates of surronding hospitals for the same thing. If there rates are higher than other places, it gives you something to show that they overcharged you.
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Check with a good attorney (yeah I know the cost but explain your situation) and see what can be done.  Yes I have heard those special helicopter rides are huge, but then again I would rather get somewhere quickly and get taken care of then have a 2 or 3 hour drive in traffic when anything could happen.  Set up a payment plan, there is not much they can do if you tell them you can only pay a minimal amount.  take one day at a time (I know I worry about bills too) but its about all we can do.  take care of the most important things (electric/phone) then the medical stuff on a payment plan.  as far as Medicaid, it doesn't hurt to ask and find out.  wishing you luck but do NOT give up.
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