According to statistics, about half of all Americans carry medical debt. Perhaps you're scheduled for surgery but:
- don't have health insurance,
- can't afford the deductible or
- can't afford to miss work after the procedure
The good news is that there are many ways to get your medical operation covered.
In this article, learn how you can get financial assistance for surgery. That way, you’ll be able to recover without worrying about a shocking medical bill.
Can You Really Get Surgery For Free?
The good news is that you can get surgery for free or at a discounted price with the right programs. Here are circumstances when you might access financial help for your operation:
Help paying for surgery if you don’t have insurance
If you are one of the 28 million Americans who don’t have health insurance, don’t fret.
You can undergo surgery for free through Medicaid. Even if you’re not under Medicaid right now, it can cover you for three months retrospectively. This means you can sign up even after your surgery.
For pregnant women and children, the Children’s Health Insurance Program (CHIP) can also cover surgery expenses.
If you don’t qualify for either, the following qualifying events allow you to start private health insurance at any moment:
- Adopting a child
- Getting married
- Having a baby
Help paying for surgery if you do have health insurance
Even with health insurance, deductibles and out-of-pocket expenses can be extremely high.
Thankfully, many hospitals offer payment plans that allow you to pay for your surgery over time.
Financial assistance if you can’t miss work after surgery
A loss of income while out of work after surgery can put a strain on your budget.
That’s where short-term disability insurance comes into play. Short term disability insurance is a viable option to cover up to 60% of your lost income after surgery.
This coverage pays for medically necessary surgeries only. You can apply for the benefits if you already have a policy in place.
Financial Assistance Programs That Can Help With Your Surgery
According to a study, one out of four Americans struggle to pay medical bills. Fortunately, you can rely on the following programs for financial aid.
Medicare
Medicare is a federal program that offers affordable health insurance for seniors over 65 years. In some cases, Medicare pays medical expenses for younger people with disabilities. Here is a breakdown of the coverage:
Part A
Medicare Part A covers inpatient hospital stays, home care, hospice care, and care in a nursing facility. The program pays 100% of the costs for 60 hospital days and up to 20 days in a nursing facility.
Sign up for Part A when you turn 65 and are still working.
Part B
It covers inpatient surgery, outpatient care, and medical supplies. Medicare Part B pays for 80% of the approved amount.
You are eligible for Part B if you are 65 years and have been on Social Security Disability Insurance (SSDI) for two years.
Part D
Medicare Part D covers prescription drugs you need after surgery. It pays for around 74.5% of your medication costs. Part D is for patients aged 65 or older and with a disability.
Medicare covers medically necessary surgeries that fall under the following conditions:
- Treating an illness or disease
- Managing an injury
CHIP
The Children’s Health Insurance Program (CHIP) provides low-cost health insurance to kids (under 19 years) in families that make too much money to qualify for Medicaid. In addition to that, CHIP covers low-income pregnant women in the following states:
- West Virginia
- Colorado
- New Jersey
- Rhode Island
- Virginia
- Missouri
CHIP covers surgery, in-home care, inpatient services, laboratory, and X-ray services. It also caters to your prescription drugs and outpatient rehabilitation. You can expect this program to pay for part of your surgery if it’s medically necessary.
Medicaid
Medicaid is the largest insurance provider across the US that assists over 70 million people. Essentially, this government program offers coverage to the following low-income beneficiaries:
- Adults
- Children
- Pregnant women
- People with disabilities
- People aged 65 and above
According to Medicaid, low-income people might be earning a median limit of about $8,905 per year. This could be a family of three or more, depending on the state they reside.
Medicaid covers both inpatient and outpatient surgery. This program also pays for 80% of medical services performed at home, physician’s office, clinic, and hospital.
As a general rule, Medicaid pays for medically necessary. In this case, medical necessity means the surgery can treat an illness, symptom, or medical condition.
This program also covers reconstructive surgeries after traumatic medical issues or injuries. Medicaid might also consider your case if you suffer from chronic pain after an accident.
1. US Department of Veterans Affairs (VA)
Veterans can seek surgery assistance by applying for health care benefits through the US Department of Veterans Affairs. If you served in the military, you could access both inpatient and outpatient services, including surgery at VA medical facilities. Besides that, the program pays for prescription drugs.
You may qualify for health benefits if:
- You were discharged honorably
- The operation treats injuries and illnesses
- The surgery improves the quality of your life
- The medical procedure prevents future health issues
The VA program covers total costs if you have a disability or severe injury that needs surgery.
2. Patient Advocate Foundation
Patient Advocate Foundation is a non-profit that offers grants to all uninsured patients who are struggling to pay for their treatment costs. If a doctor has diagnosed you with a life-threatening or chronic disease that needs surgery, the charity can offer financial aid.
You can apply for assistance through the Patient Advocate Foundation. This program will pay half of the amount for your operation, outpatient care, and prescription drugs upon approval.
3. Patient Access Network Foundation
Patient Access Network Foundation (PAN) provides medical grants to underinsured people. It is one of the charities that help pay for surgery if you have been diagnosed with chronic and rare diseases. Another qualification is to have a low income at or below the Federal Poverty Level.
Usually, Patient Access Network Foundation cost-shares with you expenses related to surgery and medicine. It also pays half of your travel costs and insurance premiums.
4. HealthWell Foundation
HealthWell Foundation is a charitable organization that helps underinsured individuals pay medical bills. This organization offers financial aid for the following:
- Prescription copays
- Deductibles
- Premiums
- Travel costs
- Out-of-pocket costs
You can get half of the money you need for your surgery and drugs. The right candidate for this foundation has a life-threatening illness that requires an operation.
5. Kaiser MFA Program
This charity offers financial assistance to all patients who need medically necessary care. It helps low-income, underinsured, and uninsured people in the US.
Kaiser MFA Program also pays for your surgery, medication, and out-of-pocket costs after surgery. It covers part of the expenses for your treatment.
Other Ways to Get Surgery For Free or Affordably
There are multiple ways to get surgery for free or affordably, such as:
Payment Plans
If you need surgery without health insurance, strike an informal agreement with a hospital or surgeon. You can deposit monthly payments or ask for a discount for your medical operation.
Crowdfunding
GoFundMe is an online fundraising platform that you can use to collect money for surgery. The best part is that you can set a target amount and get the whole sum to cater to your expenses.
Medical Tourism
Also known as international surgery, you can seek treatment outside the United States. An experienced surgeon educated and trained in the US may perform the procedure at a reduced rate of 75%.
Home Equity
You can use your home as collateral to borrow a loan for your surgery. For instance, if your home is valued at $250,000 and you owe the bank $150,000, you could borrow against the $100,000 in equity.
Personal Loans
If you don’t qualify for government grants, try personal loans from a bank or a lending company. Your income and credit score play a crucial role when seeking such loans.
Borrow From Retirement Savings
You can take a loan from your 403b or 401k retirement savings, depending on the amount you’ve saved up. Typically, plans differ based on employers, but you can withdraw about 50% of the balance for healthcare bills.
Types of Surgeries You Might Get Assistance For
As aforementioned, you can get financial aid if your surgery is medically necessary. Here are two types of surgeries you’re likely to get assistance for:
Elective Surgery
The elective procedure doesn’t require a medical emergency. Therefore, you can take time to organize your finances or apply for coverage and grants. It’s easy to get funds for the following elective surgeries:
- Breast reduction
- Weight loss
- Cataracts
- Orthopedic surgery
- Total joint replacement
- Lumbar spinal fusion
Reconstructive Plastic Surgery
Plastic surgery should be primarily for medical reasons to get financial help. You might need proper documentation showing body or facial defects when applying for this assistance. Below are some plastic surgery procedures that you can access grants partly or in full:
- Breast reconstruction
- Excess skin removal
- Rhinoplasty
- Gynecomastia
As for cosmetic surgery, insurance won’t pay for the expenses since it’s purely aesthetic. However, you can take a loan for this procedure.
Final Thoughts
Thanks to multiple government programs and charities, getting surgery at an affordable rate is possible. These medical grants can ensure you don’t sink into debt after your surgery. The best part is that you can utilize arrays of sources of financial aid for the same surgery. Explore the above financial options to reduce your surgery costs.
Aidan has been writing about personal finance for over 6 years. Prior to this, he worked as a Corporate Finance Analyst where he specialized in Due Diligence, Company Valuations and more. He is a CFA charterholder.
