YANMD but how best to strategize insurance for a head trauma visit?
April 2, 2023 4:30 PM Subscribe
Sooooo, I got whacked in the back of the head by a falling 2x4 yesterday while working on a project. Raised an impressive cartoon-quality goose egg. I did not pass out. I did not bleed. I did cry. I was in a lot of pain. I took ibuprofen and then took it easy. I’ve been intentionally laying really low today, and I assume my dull headache is to be expected for the bruise that is surely there. I’m fatigued, and I’m pretty sure the head congestion is spring allergies (because I had it before the blow yesterday). Apart from that, I have bent over a couple of times and felt a bit dizzy. If I decide to visit a healthcare provider, is there a way to do that strategically for optimal coverage?
I am 50-something and generally healthy. As a result, I never have need to see a doctor or take meds, so I have a high deductible health plan thru my employer. I live in a small town with a hospital, and everyone goes to the walk-in ‘express clinic’ there for just about anything that doesn’t allow for advance planning. A friend has begun to freak me out with scary stories of similar head trauma that led to weeks-later disorientation, emergency air lifts (to the big city hospital), seizures and cranial surgeries. So if I decide I should go in for a scan (or something), based on real experiences and what you might suspect around optimal outcome for insurance coverage, would that be an express clinic visit? An ER visit? Or a call to the doctor for an appointment (where, in all likelihood they would send me to one of the other options).
And if it all depends on what kind of HDHP I have, what are the buzzwords to look for on my policy? Washington State, in case that’s a factor. And worth stating again: I know you are not my doctor.
I am 50-something and generally healthy. As a result, I never have need to see a doctor or take meds, so I have a high deductible health plan thru my employer. I live in a small town with a hospital, and everyone goes to the walk-in ‘express clinic’ there for just about anything that doesn’t allow for advance planning. A friend has begun to freak me out with scary stories of similar head trauma that led to weeks-later disorientation, emergency air lifts (to the big city hospital), seizures and cranial surgeries. So if I decide I should go in for a scan (or something), based on real experiences and what you might suspect around optimal outcome for insurance coverage, would that be an express clinic visit? An ER visit? Or a call to the doctor for an appointment (where, in all likelihood they would send me to one of the other options).
And if it all depends on what kind of HDHP I have, what are the buzzwords to look for on my policy? Washington State, in case that’s a factor. And worth stating again: I know you are not my doctor.
Agree that you should just go to the ER today and get checked. You likely have a concussion, and yes sometimes head knocks do get more serious after time has passed.
When I have non-excruciating reasons to visit the ER, I choose what I imagine will be a less busy time of day (evening? night?), and I wear comfy layers, bring a phone charger, snacks, drinks, insurance cards, etc, and expect to be there for a while. Feel better soon!
posted by nouvelle-personne at 5:10 PM on April 2, 2023 [6 favorites]
When I have non-excruciating reasons to visit the ER, I choose what I imagine will be a less busy time of day (evening? night?), and I wear comfy layers, bring a phone charger, snacks, drinks, insurance cards, etc, and expect to be there for a while. Feel better soon!
posted by nouvelle-personne at 5:10 PM on April 2, 2023 [6 favorites]
Yeah don't overthink this just go get seen. Most concussions are not a big deal but if you have internal bleeding it's potentially v serious. Was this a work related thing? That will change the insurance situation.
posted by leslies at 5:17 PM on April 2, 2023 [1 favorite]
posted by leslies at 5:17 PM on April 2, 2023 [1 favorite]
Having had to go to the ER last year, ugh. I would start with Urgent Care, but if they have any major concerns, they will send you to the ER. Which is not inexpensive, nor fast. And you will have to pay them both in that case.
But, it is also your brain box. It's kind of important.
posted by Windopaene at 5:28 PM on April 2, 2023 [3 favorites]
But, it is also your brain box. It's kind of important.
posted by Windopaene at 5:28 PM on April 2, 2023 [3 favorites]
It's unclear from your post, but if this was a work-related injury, you can expect workers comp to take care of a lot of this for you.
posted by NotMyselfRightNow at 5:55 PM on April 2, 2023 [3 favorites]
posted by NotMyselfRightNow at 5:55 PM on April 2, 2023 [3 favorites]
I think the biggest expenses here would be imaging, so you want to insure that if you get it it is because you need it. Otherwise I agree er, not urgent care as they won't be able to do the work up and may transfer you out which would be an ambulance ride plus er plus urgent care.
I fell down some stairs and hit my head on some concrete. I went to my primary as there was no loss of consciousness and no nausea or vomiting. I ended up with a pretty severe concussion and really wish I'd gone to the ER for further work up and documentation. I missed a week of work, I should have taken more. I wasn't back to myself for over 6 months. I advise that you aren't an idiot like me.
posted by AlexiaSky at 6:00 PM on April 2, 2023 [4 favorites]
I fell down some stairs and hit my head on some concrete. I went to my primary as there was no loss of consciousness and no nausea or vomiting. I ended up with a pretty severe concussion and really wish I'd gone to the ER for further work up and documentation. I missed a week of work, I should have taken more. I wasn't back to myself for over 6 months. I advise that you aren't an idiot like me.
posted by AlexiaSky at 6:00 PM on April 2, 2023 [4 favorites]
By "project" do you mean "construction jobsite" or "personal project"? I was reading this as a worker's comp situation at first but maybe I'm confused.
posted by cnidaria at 6:38 PM on April 2, 2023
posted by cnidaria at 6:38 PM on April 2, 2023
Like the man said, you need your head; your brains are in it. Worry about strategizing later. Go to the ER.
In future, if you're going to be on an HDHP, especially as a somewhat older person, you've got to set something aside for occurrences like this. HDHPs are meant to be coupled with contributions to a Health Savings Account, but if you don't have one/your employer doesn't offer it and you insist on being on an HDHP, you need to put some money away yourself. You don't want to be in a situation like this again. This is how you end up ignoring niggling little things that end up being big terrible things down the road.
posted by praemunire at 7:18 PM on April 2, 2023 [2 favorites]
In future, if you're going to be on an HDHP, especially as a somewhat older person, you've got to set something aside for occurrences like this. HDHPs are meant to be coupled with contributions to a Health Savings Account, but if you don't have one/your employer doesn't offer it and you insist on being on an HDHP, you need to put some money away yourself. You don't want to be in a situation like this again. This is how you end up ignoring niggling little things that end up being big terrible things down the road.
posted by praemunire at 7:18 PM on April 2, 2023 [2 favorites]
I am 50-something and generally healthy. As a result, I never have need to see a doctor or take meds, so I have a high deductible health plan thru my employer.
Not really here or there wrt this question, but I imagine that most every high deductible plan covers 100% of preventative care like mine does; the healthy, no regular meds 40 year old writing this paragraph suspects that is something that you should be taking advantage of in your 50s.
As far as 'optimizing' coverage for this visit, I don't imagine that you are going to hit your deductible, so you will be paying out of pocket for the full cost. You should just make sure that you are "in-network" because the in-network deductible will generally be lower and then will cover a lot more after you meet it, should you need additional care this year.
Finally, consider funding an HSA if you aren't. The money that you use to fund it is tax-advantaged, and it doesn't expire and can even earn interest if you remain healthy. You'll use it eventually; sooner or later, almost everyone in the USA is going to spend a lot of money on medical care.
posted by Kwine at 7:23 PM on April 2, 2023 [1 favorite]
Not really here or there wrt this question, but I imagine that most every high deductible plan covers 100% of preventative care like mine does; the healthy, no regular meds 40 year old writing this paragraph suspects that is something that you should be taking advantage of in your 50s.
As far as 'optimizing' coverage for this visit, I don't imagine that you are going to hit your deductible, so you will be paying out of pocket for the full cost. You should just make sure that you are "in-network" because the in-network deductible will generally be lower and then will cover a lot more after you meet it, should you need additional care this year.
Finally, consider funding an HSA if you aren't. The money that you use to fund it is tax-advantaged, and it doesn't expire and can even earn interest if you remain healthy. You'll use it eventually; sooner or later, almost everyone in the USA is going to spend a lot of money on medical care.
posted by Kwine at 7:23 PM on April 2, 2023 [1 favorite]
Response by poster: Thanks for your comments everyone! This was a personal project, not work related. I have a fully funded HSA, no worries there. Was just wanting to be strategic in case that is even possible. Also, the express clinic (what I assume is synonymous with urgent care) is literally across the hall from the ER, and these are the two things we have available within 90 minutes (also why everyone in our town purchases airlift insurance).
posted by AnOrigamiLife at 8:34 PM on April 2, 2023 [1 favorite]
posted by AnOrigamiLife at 8:34 PM on April 2, 2023 [1 favorite]
Go to the ER. If you go to the express clinic first, you will likely have to pay them, then pay the ER. Go now. With a friend. You would likely benefit from a neurological exam (can be done at the urgent care) and a scan or multiple scans (likely cannot).
Hopefully this is an expensive nothing. Better than being an expensive something. You are not thinking clearly about this. Sorry.
posted by latkes at 8:44 PM on April 2, 2023 [3 favorites]
Hopefully this is an expensive nothing. Better than being an expensive something. You are not thinking clearly about this. Sorry.
posted by latkes at 8:44 PM on April 2, 2023 [3 favorites]
100% ER, urgent care/express clinic will not have the CT scan that you will be getting to rule out internal bleeding. ER visits are generally covered without concern for in/out of network.
posted by Pantengliopoli at 10:34 PM on April 2, 2023
posted by Pantengliopoli at 10:34 PM on April 2, 2023
I'm biased (because of this story in my Ask history), but at a bare minimum I would be phoning my primary care provider for advice. I would ask the intake/front desk people for some urgently-needed feedback on what I should do next.
If you can't get that feedback quickly, based on your dizziness and fatigue, I would go directly to the ER. "Trouble with balance and coordination" is a textbook rationale for an emergency consultation after a bang on the head.
You can, and should, stress to the intake personnel wherever you go that you need all of this documented very clearly for insurance purposes. This won't have been their first time at this particular rodeo.No matter, you can always sort out paperwork as needed afterward. I think your first pripiruty is a consultation, by anyone, documenting the status quo. You need a baseline for comparison while you recover for this should (heaven forefend) any unpleasant changes develop.
Hang in there.
posted by late afternoon dreaming hotel at 1:29 AM on April 3, 2023
If you can't get that feedback quickly, based on your dizziness and fatigue, I would go directly to the ER. "Trouble with balance and coordination" is a textbook rationale for an emergency consultation after a bang on the head.
You can, and should, stress to the intake personnel wherever you go that you need all of this documented very clearly for insurance purposes. This won't have been their first time at this particular rodeo.No matter, you can always sort out paperwork as needed afterward. I think your first pripiruty is a consultation, by anyone, documenting the status quo. You need a baseline for comparison while you recover for this should (heaven forefend) any unpleasant changes develop.
Hang in there.
posted by late afternoon dreaming hotel at 1:29 AM on April 3, 2023
Um, I just watched a show in which a guy was throwing up and had a killer headache after a head banging and then he died. So if that stuff is happening, please go to the ER.
posted by jenfullmoon at 9:40 AM on April 3, 2023
posted by jenfullmoon at 9:40 AM on April 3, 2023
Can you let us know you're okay?
posted by praemunire at 1:02 PM on April 3, 2023 [3 favorites]
posted by praemunire at 1:02 PM on April 3, 2023 [3 favorites]
« Older GOAL SETTING ; or how to overcome existential... | Unexpected death of an ex halfway across the... Newer »
This thread is closed to new comments.
Later, if they want you to arrange your own scan or other subsequent care, you’ll probably want to look on your insurance website and see which facilities are covered.
posted by chesty_a_arthur at 5:00 PM on April 2, 2023 [8 favorites]