Hurricane Harvey is looking big and ugly. If you are anywhere near coastal Texas, keep on heading inland and to higher ground. Everyone else, let’s talk health insurance.
— Ed Vallee ? (@EdValleeWx) August 25, 2017
If this is the scenario that plays out, people will be kept away from their coastal homes for a week because of the storm and who knows how long due to emergency recovery efforts from the floods, storm surge and wind damage. If that is the case, people with narrow network health insurance will be in a pickle.
Almost all coverage will have an out of area component for emergency services. If an evacuee from the coast has a heart attack in Austin, they will be covered. That is not the concern.
Instead the concern that I have is for urgent but not life threatening emergency care. If an evacuee has an asthma attack and needs to go to an urgent care, that clinic might not be in network although every in-network clinic could be under water. If someone is having a significant anxiety flare-up and needs to talk with a mental health professional and there are no in-network mental health professionals within 100 miles that is currently open, that is a problem. If someone has a tumor where the current course of guideline concordant care is watchful waiting and needs an advanced scan to continue the watchful waiting, the nearest available in-network scanner might be seven counties away.
These are the tough cases of narrow networks in a major, prolonged evacuation. Most people in a short term evacuation will be able to defer their care needs without significant harm. But there are a class of cases which are urgent and should not be deferred but will not qualify as standard emergency care. These are the problems.
If you are in this class of people, the first thing to do is call your insurance company and try to get a pre-authorization. They don’t want to pay out of network prices but they really don’t want to be sued for breach of contract for denying you medically necessary care that their network is incapable of providing. They really don’t want to be highlighted on the 6 o’clock news for doing that. You might not get pre-authorized to the doc that you want but you should get a pre-authorization. Secondly, save the bills. Save all your documentation. Save your notes from the phone calls including the first and last name of the person you talked with, time, date, questions, answers and follow-up questions needed for clarification. If things get messy, a complete contemporary paper trail is a wonderful thing.
Finally, stay safe.