Do I need Medical Care?
Many survivors don’t have physical injuries from their assault like cuts and bruises. It is really common not to have visible injuries. Just because you don’t have them, doesn’t mean you weren’t sexually assaulted. You deserve to feel safe and get care to make sure your body is healthy even if you don’t visibly see injury. Some people can feel guilty, embarrassed, or ashamed and don’t want anyone to know. Your options (if you are between 18-69 years old) allow you to get medical care without police knowing.
Survivors have the option of seeking support at a medical facility that provides specialized sexual assault survivor care, such as the Sexual Assault Nurse Examiner (SANE) program or Forensic Nurse Examiner (FNE) program. These programs use specially trained nurses who work with you to make sure you are okay. If you want, they can also work with you to document the assault and collect forensic evidence.
SANE and FNE nurses are specially trained to support survivors. You can speak with them confidentially (if you are between 18-69 years old) about your needs at no cost. Seeking medical support does not mean the assault is reported to the police unless you want them to call or if they are required to make a mandatory report by law (see below for mandatory reporting details). If you choose for the police to be called or the medical professionals must make a mandated report, you do not have to speak with them or give your name.
Not all medical facilities have SANE or FNE programs. You can search for the nearest facility using this tool. These programs understand the laws designed to assist you, and can even cover some portion of an exams if you do not have or want to use health insurance.
A little more information about seeking medical care after a sexual assault:
Specialty sexual assault medical care programs are called Sexual Assault Nurse Examiner (SANE) programs or Forensic Nurse Examiner (FNE) programs.
The exam is called a medical forensic exam (MFE), but you may know it as a rape kit. The medical part of the exam is to check in on your health and the forensic portion is to collect possible forensic evidence. Forensic evidence can be DNA from the perpetrator.
SANE and FNE nurses work with you, make sure you are okay, and can collect evidence, if you would like. Nurses in these programs are trained to understand the difficulties survivors experience. They understand it can be difficult for survivors seek help and the effects sexual assault can have on a person. You can speak with them confidentially about what happened and next steps.
The exam itself is called a medical forensic exam (MFE), but you may know it as a “rape kit”.
MFEs to collect forensic evidence are always optional. If you want one, your nurse must provide one to you. In general, MFEs are best performed within seven days of the assault because forensic evidence can be washed away after that period of time. Even if the assault occurred more than seven days ago, it is always a good idea to seek medical care from a trained practitioner.
The SANE or FNE will explain the MFE process to you as well as your reporting options.
Depending on the SANE or FNE program you visit, you may also speak with a social worker and/or a confidential community–based sexual assault victim advocate. They are there to help and support you. You are not required to speak to them. It is completely your choice. Once you decide on a reporting option, you will sign a consent form, identify the reporting option you want, and if you want evidence collected during the exam. You may also have to sign additional general consent for service forms depending on the hospital’s policies.
During the MFE, a nurse will ask about what happened, collect potential evidence from your body (if you want it done), and recommend any additional treatment for your health. After the exam, the MFE is sent to a crime lab, if you consent.
The MFE can take a few hours and goes as fast or slow as you need. The nurse will explain each step to you before they do it. You can decline any part of the exam you don’t want to do. The evidence collected is stored in an envelope (a “kit” or “sexual assault evidence collection kit”). It is optional to add your name to the evidence. Afterwards, the evidence is sent to the police.
You should never be charged for getting a medical forensic exam. But there are often hospital charges that go along with it that you may need to pay (i.e. x-rays, certain medications, etc.).
Depending on if you report to police, either the police or the SAVE fund will cover a portion of your exam. The Sexual Assault Victim Emergency Payment Program (SAVE) administered by the Division of Criminal Justice (DCJ) can help up to a certain amount. If you have insurance and want it billed, the hospital will bill it first. It is important to consider who else is on your insurance and if you are okay with them seeing the exam on the bill. The hospital will bill the police, DCJ, or your insurance directly so you should never get a bill for the forensic evidence collection portion. You will be responsible for paying for any costs that police and the SAVE fund don’t cover.
If you seek medical care after a sexual assault, but do not have evidence collected and do not report to the police, then it is likely your insurance provider will be billed for the cost of your medical care. If you do not have insurance, you can work with your medical provider to set up a payment plan or work with your victim advocate to identify other possible funding sources.
If you do not have evidence collected but do choose to report to law enforcement, then you would be eligible to apply for Colorado Crime Victim Compensation to cover your medical care. A victim advocate can assist you with this process. You can find a list of advocates in your area here.
The coverage of the costs of the exam can be confusing. You can contact a local advocate in your area or CCASA if you have specific questions.