L_Saki
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Is there anyone here on Spoutible who can help this Canadian engage the US healthcare system? I have an elderly relative in Texas whose insurance company is withholding authorization for scans, delaying cancer treatment. Diagnosis was almost 2 mo ago. #USHealthCare #PatientAdvocate #ElderCare
10:08 AM - Jan 10, 2024 (Edited)
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L_Saki
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Many thanks to everyone for their input, advice and support. There have been many steps forward for which I am so grateful.
02:37 PM - Jan 11, 2024
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L_Saki
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This is the latest message though, and I am finding it incomprehensible: "Chemo medication is not approved by Humana; we don't when we can start chemotherapy" #USHealthCare vs #CdnHealthCare
02:40 PM - Jan 11, 2024
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Louise Marley
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In response to L_Saki.
For what it’s worth, try the state insurance commissioner’s office. Some are better than others, I’m afraid.
11:04 PM - Jan 10, 2024
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April Sparkles
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In response to L_Saki.
💛
10:53 PM - Jan 10, 2024
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Just Piper
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In response to L_Saki.
Are they part of an Advantage Care plan like Humana, etc? I know my grandparents and aunts and uncles are all part of one of those. Most of those will cover cancer care, but all have ‘panels’ that could disapprove procedures. Worst healthcare among industrialized countries. Hope it works out.
10:30 AM - Jan 10, 2024
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Whoa!
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In response to L_Saki.
Wouldn't hurt to get in touch with an Ombudsman. Should be posters all over the hospital with name and contact info for the ombudsman for the area.
10:19 AM - Jan 10, 2024
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Whoa!
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In response to Whoa!.
Also any of the hospital doctors or nurses should give you the information for reaching the ombudsman upon your request.
10:51 AM - Jan 10, 2024
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Miss Lil' Bit Angie
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In response to Whoa!.
That's what I was going to suggest. Hospital systems have patient advocates for these type of situations. Also the insurance company should also have a grievance department. There's no reason why this isn't covered. 💜♾️
11:01 PM - Jan 10, 2024
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RA
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In response to L_Saki.
As a former elder caregiver, my advice is to either ask for a patient advocate at the hospital and/or to hire an outside care coordinator to do the legwork and check in on your relatives. It sucks that we have to fight so hard to get coverage, but there are professionals who do that.
10:17 AM - Jan 10, 2024
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RA
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In response to RA.
Also, depending on where they are, the local Visiting Nurses Association (VNA) or the local Council on Aging may be able to direct you to someone who can help.
10:19 AM - Jan 10, 2024
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L_Saki
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In response to RA.
Thank you. The hospital patient advocate was contacted, but the CT scan that was supposed to be this morning still didn't happen. It's helpful to know at least the patient advocate is the way to start.
10:20 AM - Jan 10, 2024
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