How to Deal with a Medical Crisis

Medical experts answer more than two dozen key questions—about second opinions, clinical trials, the limitations of insurance, and other significant topics—to help patients map a road to recovery

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25.
What do I do if I have to leave my job?

•  Immediately after leaving, you can extend your health insurance for 18 months under COBRA, the federal law that includes a temporary-insurance program. When you are employed, both you and your employer usually pay a portion of the cost of your health insurance; with COBRA, patients usually pay both portions, so month-to-month costs will likely go up if you enroll.

If your medical problems prevent you from returning to work—any type of work, not just the job you leave—you can apply for disability pay through Social Security. If you and your doctor decide together that you will be out of work for more than a year, you should consider applying for Social Security disability. Rabin suggests you hire a lawyer with expertise at the beginning of the process. (Lawyers working on Social Security disability cases are paid a portion of the eventual payments, so you are not on the hook for fees if you ultimately get denied.)

Disability should be a last resort. “It’s always better to work than be on disability,” Rabin says.

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26.
How should I tackle the insurance bills that arrive?

•  “Open ’em,” says Erin Schneider, an American Cancer Society patient navigator at Rush. Letting the envelopes stack up in a deal-with-later pile is tempting, but that approach can quickly lead to collections notices. “It’s like anything else: Put something aside and then it grows into something really big,” says Susan Loeb, the benefits advocate. “Procrastination gets to be costly.” It doesn’t help that many of the papers that arrive are covered in abstruse abbreviations and frighteningly large dollar amounts but no instructions for you. Here is the quick-and-dirty summary of what it all is:

The hospital tracks what it has provided and sends a statement showing base charges. The insurer reduces these charges according to contracts with the medical providers. Of the remaining amount, the insurer pays the provider a portion, according to your personal insurance plan. The insurer should then send you an “explanation of benefits,” indicating how much is still owed. Soon afterward, the provider should send you a bill for this unpaid balance. It’s a lot of mail.

Loeb suggests organizing it by date of service, which is the date you actually received the care mentioned on all the statements. The computer-savvy might track it all with a spreadsheet, to see more information at a glance. If you are looking to simplify this mountain of paper, Schneider suggests looking only for bills with the tear-off portion and instructions on sending payment: “If it doesn’t say you have to pay, just ignore it.”

For people who feel buried by the paper, there are services for hire that can review the claims for you. They tell you what to pay when you have been billed accurately, and they call the insurance company to resolve errors or appeal denials. Locate one near you through the Alliance of Claims Assistance Professionals’ Web site at Claims.org. In some cases, the money a professional saves a patient in errors spotted or denials reversed can pay their fee. Most claims assistance professionals charge between $60 and $100 an hour.

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27.
What should I expect during follow-up care?

•  Follow-up care presents its own problems. Many patients don’t foresee the continued anxiety they feel after they have been pronounced disease-free. “Some people have significant emotional scars. Some people may be physically changed,” says Richard Schilsky, an oncologist at the University of Chicago. “All those things can affect people’s relationships.” He says some studies have shown that cancer survivors can experience a condition similar to posttraumatic stress disorder.

“There may be that anxiety at scans and at follow-ups,” says Gauthier, the Rush psychologist. “Even after [patients] are finished with treatment, they’re always going to deal with some of this uncertainty.” Treatment offers regularity and a sense of progress toward beating the illness. Reaching the end of treatment and staring at the unknown that lies beyond it can be unsettling.

Know how to reach your doctors in case you are worried about symptoms after treatment. Keep going to a support group, if you have joined one; if you haven’t, there’s nothing stopping you from doing it now.

Most important, follow your doctors’ advice about when to schedule return appointments. Continue to see specialists periodically.

And figure out what is normal for you now. It may not be the same as before you were diagnosed, but different isn’t always worse. It can even be better. “It’s very easy to focus on the difficulty—which one can’t deny,” says Tobin, the psychiatrist at the U. of C. “It can also be an incredible time of personal growth, a time of bringing families together.” Sickness insists that we recognize human frailty, but more quietly, it reveals human beauty through generosity, charity, and warmth. It’s often the paradox of illness that when you look back at a period that was dominated by pain, what you see first is love.

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illustrations: Harry Campbell

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comments
5 years ago
Posted by Anonymous

I purchase Chicago Magazine from the news stand nearly every month. On the cover page for this article in the magazine, it says "To access Last year's Top Doctors List, visit chicagomag.com and enter the code chicagomagdocs".

And, on the cover of the magazine, it says "TOP DOCTORS Get Access to our List see p.61".

This is very misleading, as your web site does not allow access to the list, even with the above stated code, unless you are a subscriber. Is that correct or am I doing something wrong?

5 years ago
Posted by Chicago Magazine

We're having some technical difficulties with the passcode. If you can please create a free online account at https://www.chicagomag.com/Chicago-Magazine/My-Account/ you'll be able to access the Top Docs list right away.

We apologize for the difficulties.

If you have any questions please email us at feedback@chicagomag.com

5 years ago
Posted by eworon

I am entering "create an account"

5 years ago
Posted by debrasue

I created an online account and I still can't access the doctors list.

5 years ago
Posted by AMS

Creating account

5 years ago
Posted by Bill O.

If you're having problems creating an account, feel free to contact me at boakes@chicagomag.com


Bill Oakes
Manager, Chicagomag.com
boakes@chicagomag.com
312-832-6745
Chicago Magazine | 435 N Michigan Avenue, Ste 1100 | Chicago 60611

5 years ago
Posted by meggie

I ordered the top docs magazine for the list of top docs because my son moved to Chicago. I was trying to find out what docors were good. I paid seven dollars to have the magazine sent to me in Michigan and I have not one doctors name. I read the above comment and I also can't access the names. I get Hour Detroit and they always have the list in their magazine and I thougt you did the same thing.

5 years ago
Posted by ellenw

I have a subscription to Chicago Magazine, but cannot access the top doctors'list. Please tell me how to proceed. Thank you. Ellen W.

5 years ago
Posted by Helen

I also tried to access the list and am having no such luck. Why can't you just publish it every year like you used to. I found it very helpful and have saved these magazines for years. I am now trying to access the list. Are you going to fix this problem?

5 years ago
Posted by katiecooke

hello

5 years ago
Posted by Lisa M.

Did anyone get the list of top doctors to work? If so plz tell me how.

5 years ago
Posted by Chicago Magazine

Per our arrangement with Castle Connolly Medical Ltd., we have removed our Top Doctors list from chicagomag.com. We posted that list, first prepared exclusively for Chicago’s January 2008 issue, as a supplement to our January 2009 feature How to Deal with a Medical Crisis. Castle Connolly allowed us to keep that list up on our Web site for only three months.

That doesn’t mean you no longer have access to the list. While supplies last, copies of the January 2008 issue are available from Chicago at our customer service number: 800-999-0879.

Please see http://www.chicagomag.com/topdocs for more info.

Thank you.

4 years ago
Posted by Cathyculben

I had a subscription and do have the January issue for 2009. I thought the magazine listed topdocs. Now that I have an emergency, I notice that the list has to be accessed online. I have had no luck accessing the list online. Can the list of topdocs be emailed to me? If not, how can I access the list. What is the point of not including the list in the magazine?

4 years ago
Posted by clay

I would like to access the site of Top Doctors in Chicago as in Chicago Magazine

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