Staying afloat during catastrophic times

Editor's note: When Dr. Jac Pedersen and his teenage daughter recently faced life–threatening medical conditions, the 58–year–old pediatric dentist knew that the bills and time off work could bankrupt the family and close his practice.

Editor's note: When Dr. Jac Pedersen and his teenage daughter recently faced life–threatening medical conditions, the 58–year–old pediatric dentist knew that the bills and time off work could bankrupt the family and close his practice. But determination, planning — and some unexpected insurance benefits — got him through the storm. Here's what we learned from this San Luis Obispo, Calif., dentist.

DE: You and your daughter experienced major medical traumas around the same time last year. What happened?
Dr. Pedersen: I had a kidney transplant. The diseased kidney had been removed, and I was in the middle of a six–month waiting period for the new kidney when one of my daughters — I have five — was injured in a serious accident. A horse she was riding stumbled, fell, and rolled on her. She was in a coma for three days. She's OK now, and I'm getting better every day, too, but the medical bills were huge.

DE: So there was financial as well as medical trauma?
Dr. Pedersen: Yes. I really wondered if my family and I would be able to stay afloat financially, or if I would have to sell the house and close the practice. We have basic health insurance, but there were a lot of out–of–pocket expenses. Then, I remembered that I also have supplemental medical insurance, called MedCASH, through the American Dental Association. I knew it would pay something, but I didn't realize just how valuable it would be. As it turned out, MedCASH paid a daily benefit for each day my daughter and I were in the hospital, and doubled the benefit for those days when we were in intensive care. It also paid a lump–sum critical condition benefit to me because of the kidney transplant, and to my daughter because of the coma, and it paid a daily benefit when my wife, who was my kidney donor, was in the hospital. It meant so much to get those checks as the medical bills rolled in.

DE: What happened to your practice during this time?
Dr. Pedersen: I wasn't able to practice at all for more than a year, first due to the kidney disease and then while recovering from the transplant. I brought in a young pediatric dentist as an associate, so my patients were still being seen. But, of course, that also increased my overhead expenses. Here again, insurance benefits made all the difference between closing the practice and staying open. I had two disability insurance policies, one through the ADA and one through my state dental association, and both began paying me a monthly benefit.

DE: Did you experience any difficulties in getting your claims paid?
Dr. Pedersen: Not at all. In fact, the claims specialists at Great–West Life actually made me aware of benefits that I didn't realize I had. [Editor's note: Great–West Life & Annuity Insurance Company underwrites and administers the ADA Insurance Plans.] For example, they explained that I qualified for the lump–sum critical care benefit and double daily benefits for intensive care. They also recommended that I check into Social Security benefits, and I learned that I was eligible for benefits because of the kidney transplant. It was a tough time, and everything could have been lost very easily, but Great–West Life advocated for me every step of the way.

DE: Are you back to work now?
Dr. Pedersen: I'm back part time, but in a different capacity. I manage the business side of the practice, but I don't see our walk–in patients. I have to be very careful about exposure to kids' germs because the anti–rejection drugs suppress my immune system. However, I've started to handle our hospital cases — kids whose dental treatment must be done under general anesthesia either in our office or at French Hospital here in San Luis Obispo. To go under anesthesia, kids need to be relatively healthy, plus the dental surgery room is kept very sterile, and the anesthesiologist checks the kids' mouths and throats before I start my work. All of that protects me against germs, while allowing me to practice. It's been great.

DE: So you're staying busy?
Dr. Pedersen: Absolutely. I also serve on several hospital committees, and I just finished overseeing the design and building of a new office for my practice. In addition, I'm very involved in Clinica de Tolusa, a pediatric dental clinic for low–income families in Paso Robles. I was one of the founders of the clinic and serve on the board. All of this, in addition to my wife and daughters, has given me a lot to look forward to as I continue to recover.

DE: What tips would you pass along to other dentists?
Dr. Pedersen: Three things: First, a multiple health catastrophe can happen to any family, just like it did in mine, so plan for the unexpected. Second, take advantage of guaranteed issue insurance when it's offered to you. I've been uninsurable since I was diagnosed with polycystic kidney disease 30 years ago, but I had bought my disability policies as a dental student without having to take a medical exam, and the ADA's MedCASH plan was also available without a medical exam. And third, buy from an insurance company that will work for you — not against you — if you ever have to file a claim.

Editor's note: This article does not constitute legal, tax, or financial advice; please seek professional input as appropriate to your situation. For more information about the ADA Insurance Plans, visit www.insurance.ada.org or call (866) 607–5330.

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