Health care navigators take on tough questions

Health care access team members Susana and Laura. (Contributed photo)

COUNTY — When health care access team members answer the phone, they’re ready for questions that cover the range of human experience with health care, from the logistics to the potentially life-altering: Now that I have insurance, where can I find a doctor? Why is this medical bill so high? I’m worried about this lump — but what if treatment is too expensive?
“No matter what the question or issue is, I want people to know: you’re not alone,” said Laura, a nurse navigator who joined the team this year.
“We’re here to answer their questions,” said Susana, who has served as a patient services representative since 2011. “We help people to see their options … sometimes we can help give them peace of mind, too.”
The team helps connect people with health coverage, including signing up for plans through Covered California, applying for Medi-Cal, or getting short-term emergency assistance through the County’s MISP resources. But that’s often just the beginning.
“It’s great to have health insurance, but if you don’t understand your plan and how to use it, you will miss out on getting all your health needs met,” Laura said.
And even if you have health insurance, you need to renew it each year. Susana said she often helps residents who didn’t realize they missed a renewal deadline until they found themselves at the doctor’s office without coverage. In those moments of panic, an in other situations, “we’re here to help,” she said.
The team helps SLO County residents find doctors who take their insurance, helps decipher confusing medical bills, and can even serve as a go-between for residents and insurance companies or hospitals in, especially complex cases. They also help residents navigate the particulars of public and nonprofit programs — for example, transferring an elderly parent’s hospice services from another county.
There is no typical question, they say, and no typical solution. Their job is to listen carefully and then find an answer.
“I have time to listen and figure out solutions,” Laura said. “It’s not that I know all the answers, but I know how to find things out. And I don’t stop — I keep calling. Because my goal is to come back with something for that person, a solution or an option.”
Susanna said she often connects people with services they didn’t know were available.
“A lot of people don’t know they qualify,” for low-cost or free coverage, she said. “Either they don’t have the information, or they don’t know what information to trust.” In her years in this role, she’s built relationships and trust by consistently offering reliable information and showing up to offer support.
Laura’s career in health care helped prepare her for the challenge. She worked as a nurse for more than 35 years in settings ranging from emergency rooms to home health to community care and more. That experience means she speaks the language of the health care and insurance worlds, and she’s not intimidated by situations that can seem confusing or hopeless from the outside.
Her motivation is simple: “I’m really driven by wanting to make a difference, to address social justice and relieve disparities,” she said. “When I get a tough question, I just think, ‘What if this were my mom? My son? My neighbor?’”
As Susana explains: “It’s a reward seeing that you’re doing something to help.”
To learn more or get help with a health care question call 805-781-4838 or visit slocounty.ca.gov/health-care-navigation.
To sign up for health coverage during open enrollment:
Open enrollment season for Covered California began in October and continues through Jan. 15, 2019. The team is available to help residents compare plans, find discounts and sign up for insurance through this marketplace. Call 805-781-4838 or visit slocounty.ca.gov/covered-ca to get started.
Appointments are available in English or Spanish, over the phone or in person in San Luis Obispo, Grover Beach and Paso Robles.

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