Time is of the Essence
When you wake up because your tooth is throbbing–time stands still. Sixteen-year-old Selena told her mom right away and her mom’s heart sank. Her mother, Lupe, was immediately concerned, not only because her daughter was in pain, but because they had just lost their insurance when they moved into L.A. County.
Lupe called Young & Healthy by 10:00 am and by 1:00 pm Selena was sitting in a dental chair on the same day. By 1:30 pm the dentist called saying that Selena would need a root canal and a crown. Within two days she had an appointment with an oral surgeon and a crown was ordered.
Sometimes the speed of service makes all the difference. Most important, get a child out of pain, THEN tackle the insurance issues. First things first.
Having Insurance Does Not Always Translate to Access to Care
Randy, a single dad, recently and unexpectedly lost his job. The instant decline in his income qualified he and his daughter for a different kind of insurance—Medi-Cal. Young & Healthy assisted in signing them up for the Medi-Cal insurance. A few months later, Randy returned to Young & Healthy for help in accessing a cardiologist. Even though Randy was fully insured with Medi-Cal, finding a cardiologist that would take the Medi-Cal was no easy task. This was one of those times where having insurance doesn’t always mean having access to care.
A full year from Randy’s initial contact with Young & Healthy, he returned to our office to thank the case management team for helping him to finally get to a cardiologist. As it turned out, Randy had had a silent heart attack, but was now recovering well and under a doctor’s care. It was no small miracle that his daughter still has a dad.
Once again, Young & Healthy’s compassionate help and coordination assisted a client who otherwise was trapped with insurance, but without access to care when it really mattered. Our staff was relieved to know that Randy received the care he needed, and in what may have been the nick of time.
The Ups & Downs of Income…and Care
Sometimes our clients have fluctuating incomes, which means they have fluctuating access to healthcare.
Sophia was disqualified from Medi-Cal because she made too much money. The social worker from the hospital referred her to us for help in adjusting her insurance.
We found that Sophia was eligible for a plan through Covered California and she qualified for a “stipend” to help cover the costs. Unfortunately, within six months, Sophia’s income plummeted and she could no longer afford the premiums through Covered California. Back she went to Medi-Cal and back to Young & Healthy for help in navigating the quagmire of insurance changes and paperwork.
As a community, we are getting better at helping families understand WHY insurance is so important, but it still isn’t easy for them to pursue it.
Never Letting Go Until the Care is Complete
We are always happy when a child completes a full week of care at our Mobile Dental Clinic. Sometimes follow up care is needed and this was the case for 14-year-old, Benton.
Benton needed four root canals. The Herman Ostrow School of Dentistry at USC offered to perform the root canals at their downtown clinic. However, Benton’s family did not have any means of transportation. This situation brought added frustration and stress that escalated to the point that Benton’s mom wanted to drop the whole thing.
The Young & Healthy team convinced Benton’s mom that they could provide help in obtaining Medi-Cal. Once Medi-Cal insurance coverage was secured, the Young & Healthy team assisted the family with navigating the system to identify a local Medi-Cal dentist, as well as an oral surgeon, who could complete Benton’s care.
Benton is on his way to a healthy mouth and hopefully his mom feels the support of her community.
Heart & Soul
Can you imagine all the heartache and sadness that comes with being a young widower? In spite of it all, taking care of his young daughter is a top priority for Dennis. He came to Young & Healthy for help with navigating the insurance system. The Young & Healthy team helped Dennis to transfer his family Medi-Cal from San Bernardino county to Los Angeles county and assisted him in setting up primary care doctors for he and his daughter.
A few months later, Dennis came back because he was having difficulties accessing a specialty doctor. More trouble-shooting with the Young & Healthy team enabled him to secure an appointment with a cardiologist.
Thank goodness Dennis saw the cardiologist! Consumed with caring for his daughter, he hadn’t realized he had actually had a heart attack. It must be hard sometimes to tell the difference between overwhelming grief and a life threatening medical event. His insurance covered everything and Dennis is doing well.
Sometimes we might forget, among the technicalities of insurance application and advocacy, just how many lives we might be saving.