What if you have no health insurance but you get hurt on the job? Many workers are uninsured. If the workers compensation adjustor denies your claim or fails to timely pre-authorize the medical treatment you need, then here are some options you may want to look into:
1. Private health insurance (i.e., Cigna, SelectHealth, Altius, EMI Health, SelectMed, Aetna, etc.), if your job or your spouse’s job offers it.
2. COBRA health insurance from a previous employer. Contact your previous employer (Human Resources), if needed, to get information.
3. Medicaid. It can take a while to get approved, so submit an application ASAP via the Dept of Workforce Services (DWS).
4. The Doctors Volunteer Clinic of St George. This is an outstanding medical resource offered through the donations and efforts of many generous volunteers, donors and physicians. To qualify for their medical services, you must meet their income guidelines, i.e., be below 200% of the poverty level. For example, a family of four must have a monthly income less than $3,973 (which equates to $47,676 per year).
5. Family Health Care clinics in St George and Cedar City. If you do not have any health insurance they offer a Sliding Fee Discount Program based on family size and income, so a typical medical visit will cost between $25 – $80. Website: www.familyhc.org.
6. IHC Financial Assistance. Apply as soon as possible. IHC generally wants patients in need to seek financial aid from all available sources. If you meet their guidelines, they will use a sliding scale based on your income and ability to pay. IHC Financial Aid is particularly helpful if you need an urgent surgery or other procedure that a family clinic does not provide.
7. Do not remain silent – “ask [for help] and ye shall receive.”
Note: If at all possible, try to get proof that the workers compensation adjustor has actually denied your doctor’s request for pre-authorization. The legal principle here is to give the workers compensation adjustor an opportunity; if he says “no” then you’re free to go elsewhere, get the treatment, and still file a workers compensation claim for reimbursement. If you do not give the adjustor an opportunity to pre-authorize the treatment, then the Labor Commission will likely deny your claim for reimbursement. (Reference: U.A.C. R612-300-2)