Easing a patient’s worries

November 30, 2021

Recently, I assisted a young man turning 26 who is aging off his parent’s work-place health insurance plan. This individual has multiple medical conditions including cancer, mental health needs, and a previous open-heart surgery. After studying the plans available on HealthCare.gov, we found one that fit his budget and coverage needs. We wanted to make sure his medications and all four doctors were in-network. Medications checked out and all of his doctors were in-network except for his psychiatrist, upon whom he depends for mental health care and prescriptions. Josh (not his real name) was so upset to learn his psychiatrist was not in-network, he began to panic a little. I told him I would contact her office to discuss options with the insurance specialist and we would talk again later in the day.

I had a lengthy conversation with the provider’s office, and they advised he could change to another doctor within the practice, because they were all in-network for this particular plan except her. The second option was keeping the same doctor and paying out-of-pocket for services.

During our next phone visit, Josh told me he felt hopeless at lunch and cried because he thought he would have to change doctors or lose coverage. I explained the options I discussed with the provider’s office and the amounts he would pay for services if he chose to keep his doctor. Those amounts were acceptable to him. He was so relieved he could choose the plan he wanted and keep all the doctors he has come to depend on.

He thanked me numerous times and told me whatever I get paid is not enough for how much I helped him. We both laughed at that comment, and I assured him it was my pleasure to help. After ending the call, I teared up. It hit me how much people need our services and sometimes doing just a little extra makes all the difference in the world.

Jennifer Wilson is a Cover Kansas Navigator based in Topeka.