What is Medical Indigency? - Definition & Policy

Instructor: Jessica Mercado

I completed my BA in Criminal Justice in 2015. Currently working on my MS in Homeland Security Management.

This lesson will discuss the meaning of medical indigency, and what the policy is, for handling medical indigency. Criteria for determining medical indigency will also be discussed, along with examples of what medical indigency would look like in a real setting.

Worrisome Medical Expenses

Jill is a typical healthy 40 year old woman. She works two part-time jobs to help support herself and her 15 year old son. She makes only enough to barely get by. One day, she gets injured on the job and was taken to the hospital by an ambulance. Her injury, a few broken ribs and a ruptured spleen, required surgery and a hospital stay of two days. Unfortunately, Jill did not have medical insurance, and would have to pay the thousands in medical bills on her own. She was barely able to support herself and her son on her income. She now has to come up with money to pay her medical bills, along with losing money for having to take time off.

Could this be classified as medical indigency? What is the criteria and policy for dealing with type of situation?

What is Medical Indigency?

Medical Indigency is when a patient does not have the financial means to pay for their medical expenses, on top of living expenses for themselves. In the above example, Jill was barely able to support herself and her son. When she got injured on the job, and took time off to recover, her income was not sufficient to cover the thousands of dollars in medical expenses, on top of her living expenses.

Policy for Handling Medical Indigency

Each state and the hospitals in them have their own medical policies in regard to medical indigency.

The goal for health care policy in the United States is to ensure that everyone is able to get medical care when they need it, even if they are unable to pay for it on their own. For those who fall below the poverty line, and those who will become impoverished after medical expenses, they may be eligible for Medicaid, a government provided form of medical insurance.

If Medicaid is not an option, a physician may choose to provide a lower standard of care. In the case of Jill, the physician may have performed the surgery because it was life or death, but not provided any after care. Jill would have been sent home with a family member or friend. This type of care can also be considered short term and may not alleviate the patient's problem completely.

If the medical problem is serious and lowering the standard of care is not an option, the physician may suggest a safety net provider, or non-profit hospital. Non-profit hospitals or medical centers swallow the medical expenses of the patient and write it off as bad debt. This can allow uninsured or low income patients the ability to receive the care they need and allows the hospital to receive tax relief benefits to compensate for the medical costs. Jill had already received treatment so this would not be a viable option for her. However, she could continue her recovery efforts through a non-profit hospital.

Sometimes non-profit hospitals are not accessible to a patient. This could be the case if the patient in located in a rural area. If there are no accessible non-profit options, a physician may offer a discount for medical expenses. These discounts might include a discounted charge in comparison to what should have been owed or the physician chooses not to charge the patient for medical expenses and writes it off as bad debt. Since Jill already had surgery, her physician may choose one of these options.

Some states also have charity care programs that help patients receive medical care they would otherwise not be able to afford. If the hospital that Jill received her medical attention has a charity care program in place, she could qualify based on her income. The charity care program would then take care of her medical expenses.

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