Workarounds for Costly Healthcare Delays: Insurance And Other Options

As more hospitals enact triage emergency room protocols and cancel elective surgeries and other procedures, many people across the country have been placed in a holding pattern with their healthcare. The term "elective" has become more broadly defined over the last nearly two years. In the past, an elective surgery was a non-necessary procedure chosen by a patient. Yet, people who have conditions that disrupt their lives or near-life-threatening symptoms are being told, often while experiencing pain or risking permanent injury or disability, that they can't have the procedures they desperately need to prevent worse outcomes. Some people who have life-threatening conditions with comorbidities are dealing with cancelled procedures as well either because they're comorbidities place them lower on priority treatment lists or the surgeons and staff they rely upon are overwhelmed with COVID patients and a backlog of scheduled procedures.

Whatever your situation, you must never forget that delays with receiving healthcare can have short- and long-term, perhaps even life-long, negative effects on both your health and finances. Every follow-up call, email, fax and message between you and your doctors eats into the time you might spend resting, job searching or working. If your health severely deteriorates because you waited too long for a specific treatment, you might not be able to work ever again.

To prevent these scenarios and protect your savings, you need to have a support team. Take the following steps to help you receive the care you need as quickly as possible:

Ask Your Insurer for Help

Healthcare insurance companies offer a nurse case management unit to help patients who have one or more chronic or serious health conditions acquire the care they need and improve their health and wellbeing. Although a case manager can't force a doctor to bump you higher up on their schedule or see you when everything is shut down, they can serve as your go-between. They can make follow-up calls and even try to help you find another physician who can offer you treatment sooner.

Some insurers even cover long-distance medical transportation if you can't find medical care in your community and need to travel to the next available hospital or major academic research hospital. By asking your insurer for help, you also create a paper trail that shows you making every effort to gain the healthcare you need, which is important if you're unable to receive treatment and must apply for disability benefits.

Apply for Assistance

Of course, if you can't receive timely treatment, you've exhausted every option and your health is impacting your ability to function normally when trying to perform daily tasks and work, then you should apply for disability benefits. Federal disability programs, such as Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), are designed to help people with disabilities receive income when they can no longer work because of one or more disabilities.

If you're not currently receiving other types of benefits while struggling with your health and expenses, contact your closest County Assistance Office about benefits you might be eligible to receive while going through the disability application and review processes, such as heating, rental and food assistance. The case manager through your healthcare insurer might also be able to help you apply for assistance or refer you to an organization or program that offers volunteer advocacy support or other useful programs.

Hire A Lawyer

Some well-meaning people might incorrectly tell you that you can't sue a hospital or doctor for refusing or delaying treatment during a pandemic. Yet, if either has caused you severe and possibly life-long physical, emotional or financial harm, you have the right to pursue a personal injury claim. A personal injury lawyer doesn't usually charge for an initial consultation or while handling your case. They only require a payment if they win and you receive a monetary award.

At the very least, a lawyer with medical negligence and personal injury experience can give you the expert advice you need to better understand your rights as a patient. Depending on the geographic location and lawyer, you might be asked to pay a small fee for the consultation or extra advice, but the amount is worth it if you find out that you have a case worthwhile case. Some lawyers can even provide advice about or assistance with applying for disability and other benefits.

Things to Keep in Mind

It might seem ridiculous that you must go to these lengths to receive medical care in the United States, but the pandemic has exacerbated preexisting infrastructure and staffing issues in the medical industry and created a wide range of extreme and dangerous healthcare scenarios. If you don't act immediately and advocate for yourself in these ways, your worsening health might result in the sudden need for expensive, extra medical care, such as high doses of over-the-counter and prescription medications, an in-home nurse or attendant or even nursing home or hospice care. Lack of timely healthcare can even make you feel out of control and like you're losing your independence, which can also take a toll on your mental health and force you to need high-cost professional therapy, medications and other related services.

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