For people who don’t have company-based health insurance or don’t qualify for government programs, figuring out how to get individual, affordable medical care is like navigating a maze.”It’s a very piecemeal, patchwork [system],” said Matt Guy, manager of the southeastern office of the Colorado State Office of Rural Health, a nonprofit organization.Although there are programs for some people, others don’t qualify.Medicaid is not an option for adults without dependent children, said Joanne Lindsay, public information officer for the Colorado Department of Health Care Policy and Financing.For the past 19 years, people who couldn’t get health insurance because of a pre-existing medical condition used the CoverColorado program. “Some people pay a lot for CoverColorado coverage,” Lindsay said.As part of health care reform, the GettingUsCovered program was launched in September.According to www.GettingUsCovered.org, a 50-year-old, nonsmoking El Paso County resident with a pre-existing condition can get coverage for $374.40 per month with a $2,500 deductible.To be eligible, one must be a United States citizen or lawfully present in the United States, a resident of Colorado and have been without coverage for at least six months. Those eligible must have a pre-existing condition as well. A denial letter from an insurer, a letter from an insurer excluding coverage of a pre-existing condition or a letter from a doctor stating the applicant has one of 34 medical conditions, including diabetes, cancer and emphysema, is required.The GettingUsCovered program is administered by Rocky Mountain Health Plans, a Colorado-based nonprofit working with CoverColorado and Express Scripts, a pharmacy benefits manager.Because it’s federally funded, enrollment is limited.The plan is a bridge to 2014, when individuals with pre-existing conditions will be able to purchase coverage through health insurance exchanges, another part of health reform.If someone doesn’t qualify for GettingUsCovered, there are other options. In Colorado Springs, Peak Vista Community Health Centers, an affiliation of nonprofit medical providers, is available.As a federally qualified health center, Peak Vista relies on grants and patient fees to provide a range of services, including medical care, mental and behavioral health as well as dentistry, Guy said.”Those folks do a fantastic job serving the underserved, but they were originally created to serve urban areas and still do,” he said.There’s often a waiting list to join, said Patti McNab, coordinator of Memorial Health System’s Heart and Vascular Center.Peak Vista’s application form indicates that a person living alone and earning more than $25,525 might be ineligible.Colorado Springs offers another alternative for some: Mission Medical Clinic.According to its Web site, the clinic offers free medical care through the Christian Healing Network, a 501(c)(3) nonprofit organization.There’s a nine-to-12-month waiting list to visit the clinic’s volunteer dental staff and limited access to physical therapy and mental health services.Patients must verify their income at or below 200 percent of the federal poverty guidelines.The clinic provides service only to people between the ages of 18 and 64 and does not provide service to people covered by Medicare, Medicaid or the U.S. Department of Veterans Affairs. Mission Medical does not offer obstetric care but refers OB patients to Peak Vista’s Women’s Clinic.Open Bible Medical Clinic in Colorado Springs also offers free primary medical care for acute and chronic illnesses, as well as limited mental health counseling, but does not provide preventive care.According to its Web site, www.openbiblemedical.org, patients must qualify at or below 200 percent of the federal poverty level, have no health insurance, be ineligible for Medicare and Medicaid and cannot be a member of Peak Vista or Mission Medical. There could be a fee for some services that are referred outside of the clinic.SET Family Medical clinics in Colorado Springs provide basic medical services and holistic health programs to uninsured, underinsured and low-income people, but its Web site, www.setofcs.org, does not list eligibility requirements.The Colorado Indigent Care Program provides funding to clinics and hospitals so medical services can be discounted to Colorado residents who meet the program’s eligibility requirements. According to www.colorado.gov, an applicant must be a U.S. citizen or a legal immigrant residing in Colorado, must have an income at or below 250 percent of the federal poverty level and cannot be eligible for Medicaid or the Child Health Plan Plus program.To use CICP, the patient must obtain services from a CICP provider.All of the CICP providers listed by www.colorado.gov for El Paso County are located in Colorado Springs.Federally designated rural health clinics are another option, Guy said. These clinics receive additional government compensation for taking Medicare and Medicaid patients in rural areas.”Most, if not all of them, also offer services [to uninsured patients] on a sliding fee scale, so based on your income and some other factors, they’re willing to discount cash services,” he said.In Peyton, the nearest rural health clinic is the Eastern Plains Medical Clinic of Calhan.Many other health care providers offer discounts for cash payment, when payment is made at the time or soon after the service is delivered.Because of the 2009 Colorado Healthcare Affordability Act, in two years, Colorado will have a new program for adults without dependent children, Lindsay said.The program will have sustainable funding through a hospital provider fee and an income requirement of no more than 100 percent of the federal poverty level, which is about $10,000 a year for a single adult, she said.
