Hey, everyone, My MC has found himself in a mess since he ran away from home. He has lost many benefits including health insurance, which will undoubtedly make it more difficult to treat his mental health issues and allow for a sense of self-improvement, which I feel is necessary for character development by the end of the book. When his parents get into an accident and die, my character, who is 17 at the time, does not want to go through the foster care system/whatever would follow minors without parents, so he runs away to live on the streets. By the time he is around 19, things happen, which include sharing a house with multiple people and working a job in a restaurant that pays "under-the-table" (since he doesn't have the essentials like his SSN). At the same time, he can't rely on having enough money to provide for health concerns. At the end of the novel, I planned on having him check himself into a psychiatric hospital, but without insurance, what can he really do for himself? If he tries to reach out to social services (?) and admits that he had run away from home and what his dead parents left behind would be really helpful right around now, can things be arranged for him? And if not, are there any other solid alternatives that demonstrate maturity and self-love on his end?
I'm unclear on why he didn't reach out the instant that he turned 18, since at that time he couldn't be forced into foster care and he could claim his parents' assets, if they had any. It would also be safe, at that point, for him to use his SSN. So you may need him to be younger, or you may need another reason for him to be in hiding. Of course, even if he does claim his parents' assets, the medical treatment might well consume all of them and leave him broke and without access to further treatment.
You'll want to clarify your setting to ensure you get the best answers - I'm assuming the US, but I could be wrong. Where I am (Ontario, Canada) a seventeen year old would be allowed to live on his own if he wanted and would be eligible for social assistance in his own name. (But he'd also have access to free healthcare, so I'm guessing you aren't writing a story set in Canada!). You may need to do some research on your specific state to be sure of what you're dealing with in the US.
Also, at least in the US, there is something called an "emancipated minor." My mother became an emancipated minor when she was 15 and in so many ways was a complete independent with most the perks & responsibilities of an adult. She lived on her own, paid for her own apartment & necessities, was in charge of her own schooling (she opted out of high school & was accepted directly into university), and got her own stable incomes from various jobs. If my mother can become emancipated at only 15, I'm sure a 17 year old could no problem. But it'd probably be best to look at the qualifications of emancipation of minors.
If his illness is severe enough that he could be deemed a risk to himself or others, he would probably still receive treatment, even without health insurance. He might not get to go to a top-flight mental care facility, but states tend to underwrite costs in situations that would benefit the community as a whole. I can tell you that after several years any estate his parents had left would most likely have already been dealt with. Even if they died intestate (without a will), state law would provide for the distribution of any property, etc. Of course, if there is no living relative to take, the state itself would claim the property. So as far as his parents assets, if he fails to claim it after a certain time period it would be gone one way or the other.
In the US it is possible that he'd be eligible for Medicaid. Until the ACA is repealed, Medicaid does cover some mental health. If you want your character to have or not have health care, consider state variations and choose accordingly. There is no reason your character can't get an SSN unless he wasn't born in the US. He would need know the state and county he was born in and have some way to prove that is him. Shouldn't be that hard. There are usually social services to help people with things like that.
He might, but if he lacks heath insurance but has assets, the assets would likely be seized to pay the medical debts.
Thanks everyone for your advice! I have decided that he will have a brief period of (literally) running away from his problems before coming back to his house as an 18 year old, claiming his parents' assets, and living on his own. The only question I have remaining is this--will he be able to inherit his parents' health insurance or will he have to apply for it as a result of his new circumstances? The story does take place in the US (Illinois) and, as far as I can see, he could apply for Medicaid. Either way, I am definitely more confident in the issue than when I started. Thanks!
One issue with answering these questions is that if you get too specific, those specifics will likely date the book to a pretty specific year. He will in some way almost certainly have to act in order to get insurance. COBRA (1986-present, and hopefully continuing unless that's the next target after ACA) would likely allow him to buy continuing coverage if he acts soon enough after his parents' deaths, for I believe either 18 or 36 months. If your book is set before the Affordable Care Act (2010) and if he has any preexisting conditions, that might be his only way to get insurance--I don't think that he, as a single man under 65 without serious issues like blindness, could qualify for Medicaid. If ACA is in effect I think that preexisting conditions wouldn't be an issue and it would likely be cheaper to buy insurance. I believe that he could also qualify for Medicaid, if he passes the income tests. If ACA is killed, it's hard to tell. I don't know if psychiatric care would be covered, however. I could be wrong about any or all of this. I'm at about eighty percent confidence.
1/ Why does he have to have mental health issues? I know it's not uncommon, but why? If they arise (e.g. depression) because of his insecure lifestyle...I mean, is this what the book's about? 2/ Why does his recovery have to be because of treatment? Are there no self-help sort of arrangements (e.g. like how I understand Alcoholics Anonymous works). 3/ If his recovery from mental health IS because of treatment, that does away with the notion of SELF-improvement.
