The Ultimate Guide to Managing Your Healthcare Resources

The Ultimate Guide to Managing Your Healthcare Resources

Quick Summary

Healthcare has a lot of moving parts, and it can sometimes be easy to get lost in the shuffle of everything that goes… on with your health. The time is now to take back your healthcare resources to better manage your healthcare needs.  Start by taking charge of your health care when it comes to your doctors, prescriptions, insurance, and other healthcare providers.  Learn more about how you can be more than just a silent partner that blindly follows what is said by healthcare providers, but how you can open a better dialogue to get the best care possible now and in the future.

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SECTION I: Introduction to Managing Your Healthcare Resources

SECTION II: Become a Partner with Your Doctor

SECTION III: Manage Your Prescriptions Better

SECTION IV: Tackling Your Insurance Head On

SECTION V: Managing Other Healthcare Providers

SECTION VI: Pulling it All Together

 

SECTION I: Introduction to Managing Your Healthcare Resources

Patients are no longer silent partners in their healthcare decisions, and the time is now to start managing your healthcare resources.  You may be dealing with multiple doctors who prescribe multiple prescriptions, multiple hospitals, and other healthcare providers.  This can be a pretty frustrating process as it may seem that everyone is not always on the same page, and that could spell big trouble.  This is not even including the complicated world of insurance, and how frustrating the insurance company can be to talk to at times.  Although this may all seem rather intimidating to take charge of since you don’t have a medical degree, there are things that you can do to have a bigger role in what is going on with your body and care.  You are your own medical advocate!

 

Chapter 1: You Can Take Charge Of Your Health Care By Managing the Different Aspects 

Healthcare can be a very complex process, and because of the very technical nature of modern medicine, it can be a bit intimidating to deal with for anyone.  In the past, people were more willing to allow their doctors to tell them about their healthcare needs, but today, there are ways that people can become better partners in this process.  You can take charge of your health care to ensure that you start achieving a better outcome for your health and well-being.  You may have a few appointments a month or every few months where you come into contact with your doctor or other professional, so that means you are the one that will be providing your health care in monitoring your situation and taking provided meds.

You may have chronic conditions, and worry that if you speak up that you will upset the apple cart, but not speaking up can be detrimental.

Children also need to be ready to understand their parents’ healthcare situation in case of an emergency.  There may be times when they have to step up and step in as an advocate for you, and this means that you need to keep them more informed on what is happening with your current care.

 

SECTION II: Become a Partner with Your Doctor

No longer do patients need to just listen to their doctors. Opening a dialogue is vital to managing your health care.  Yes, some doctors are easier to speak with than others because of their personalities as some have that God complex, but voicing your concerns and opinions is vital to even these doctors.

 

Chapter 1: Evaluate Your Current Doctors to See if They Fit Your Current Needs

You are not stuck with your current doctors, even if it may feel that way sometimes.  Evaluate your current doctors, and determine if they are the right doctor for you.  Ask yourself if you feel comfortable speaking with your doctor, and if they treat you in the manner that allows you to be a partner in your health care.  If you are not happy with the way that your doctor is currently caring for you, it may be time to change things up.  Most insurance companies do require you to have a primary doctor on record that you use for general medicine, but you are allowed to change this doctor.  You may need to check over your plan to see what other doctors take your insurance, but it will be worth it to be more comfortable taking charge.

 

Chapter 2: Are You and Your Doctors on the Same Page with your Care?

Think of your body like a complex machine – like a car that needs everything working correctly to get a smooth ride.  When your car breaks down, you take it to a mechanic that usually can fix anything wrong with your engine or other car parts.  It would be nice if health care worked the same way, but the human body is even more complex.  This may mean that you have to visit more than one doctor because of how some doctors specialize in treating specific areas.

Going to multiple doctors may mean that you have multiple care plans with different medications and ways of attacking your health concerns.  You need to be sure that you are on the same page with your doctors on what each medicine does, and what the right treatment is for you.  Being on the same page will tell you what you need to do when you are under your own care.  This is important, but it is vital that your doctors are aware of each other and how they are treating you.  Some medicines that one doctor prescribes may have an interaction with another medication, or a treatment plan may not take into account another doctor’s treatment plan.  Make sure your doctors are aware of each other, and current treatments.

 

Chapter 3: You Should Investigate New Doctors If Necessary to Get the Care You Deserve

If you have decided that you are unhappy with your doctor because of your treatment or they are not working well with your other doctors to provide you the best care, it may be time to investigate new doctors.  Talk with your insurance company to get a list of local doctors in the specialty that you are looking for a new doctor to have, and then look over this list.  Learn about each doctor’s bedside manner, education, and other patient’s experience with the doctor.  At first, glance, take the time to see what information is available online about the doctors on your list.  There are websites dedicated to reviews on doctors that include information on them and other patient experiences with them.  Of course, reviews should not be your final deciding factor as sometimes those happiest with a doctor are not thinking about leaving a review, and those that are unhappy are more than willing to vent to anyone willing to listen.  You may need to schedule an appointment to speak briefly with the doctor to see for yourself what their bedside manner will be like since online searches can only go so far.

 

Chapter 4: Advice on How to Handle Your Doctor Appointments

Going to your doctor’s appointments may seem like a blur.  You arrive, wait, and get your short amount of time with the doctor before you are bustled out of the room for the next patient.  It’s easy to feel like a sheep being herded, but you can take charge of your visit.  Ask questions as you speak to the doctor.  If you tend to forget your questions, write them down to bring along.  This can be a good experience for your children to attend to learn more about the current care being received, things to look for, and what treatments may be necessary in the future.

The Internet is an amazing tool that has brought the world together, and there are plenty of online self-diagnostic tools when you are feeling poorly.  The key to remember is that they do not replace your doctor.  Sometimes, these tools can be misleading about what your symptoms may mean, and you may be doing more harm to your health by blinding following this information.  These tools can hold an important place when it comes to your doctor visit as you can use it as a conversation starter about your concerns.

 

Your doctors should be working together when prescribing your medications, and while you may not have control over having to take medications, you can manage them.  Some tools available to you include creating a prescription chart, finding ways to cut costs, and using your doctor and pharmacist effectively.

SECTION III: Manage Your Prescriptions Better

Chapter 1: Create a Prescription Chart for Your Records in Case of an Emergency and to Find any Discrepancies

You may be on several prescriptions that need to be taken following set directions, and often, these directions may differ.  This is a lot of important information to keep track of so creating a prescription chart can be a great idea.  You can also include your doctor’s information and any other important health information that may be necessary in the case of an emergency.

Not only will a prescription chart let you know when your prescriptions should be taken and how they are taken, but it is also a comprehensive list of what you are taking no matter which of your doctors prescribed the medicine to you.  You can take this information with you to all of your appointments for your doctors to review what you are taking.  Plus, this information is great for when there are any medical emergencies, and you are unable to remember exactly what you take, such as the name of the drug or the dosage.  This information can speak for you when you cannot or can inform your loved ones that can relay the information to your healthcare providers.

There are several ways that you can keep an organized list of your medications in a prescription chart.  You can create one online that you can print out.  There are several different types of templates to choose from when creating your personalized chart.  Some are even able in card form that will easily fit in your wallet or purse.

 

Chapter 2: Examine The Costs of Your Prescription Drugs

Prescription drug cost can be high, so you should examine the costs of the different medications that you take.  It can be a good idea to get a documented list of how much your medications cost with your current dosage and brand.  You should also contact your health insurance company to receive their formulary list as this can be used to help you to find ways to cut costs.  Your pharmacist and doctors are also great sources of information on ways you can get more bang for your buck when it comes to your prescriptions.  Your prescriptions are important or your doctor wouldn’t have prescribed them to you as they did, so skipping doses or cutting pills is not giving yourself the full benefit.

 

Chapter 3: Get Help at the Pharmacy from the Pharmacist

Your pharmacists might not seem like part of your healthcare team, but they certainly are, and should be used as such.  Often, people sign for the medications that have been prescribed to them, and never speak to the pharmacist about what they will be taking.  Your pharmacist is a fount of information that can let you know about the side effects, how to properly take your medications, proper storage, and other information that your doctor might not have let you know about when giving you the prescription.  Don’t be shy, but ask questions.  Part of their duties as a pharmacist is to help you with taking your medications the right way and keeping you informed.  They can even sometimes provide you with the right dosing tool.

One tip is to use the same pharmacy when possible as often the pharmacist is the first to spot when you may have drug interactions with prescriptions prescribed by different doctors.

 

Chapter 4: Speak with Your Doctors for Lowering Costs and Interactions

Your doctor should be your next stop when it comes to lowering the cost of the prescriptions you are taking and dealing with any potential interactions that the pharmacist may have identified.  That formulary list and prescription chart can come in handy when speaking with your doctor as they will let the doctor know what you are taking along with what similar drugs are covered by your insurance company under the formulary.  Talk to your doctor about using generics if there isn’t another brand similar enough that is covered by your insurance.

In some cases, doctors may also change the prescription to a higher dosage to let you cut the pills because often the price for the number of pills doesn’t change even if the pill’s dose is higher.  That means you can get twice the amount of doses, but at the same cost as before.  This may not work with all your prescriptions, but is a good idea for those that can be prescribed in this fashion.

Although it is a good idea to stick with the same pharmacy as noted above, shop around.  You may have a location that offers better prices on the prescriptions than other pharmacies.  For instance, if you have a warehouse club in your area, such as Costco, speak with their pharmacy about their prices.  Often, you can have your prescriptions filled with them at a lower cost without having to be a member of the club.  It never hurts to ask, and not asking might hurt your wallet.

 

SECTION IV: Tackling Your Insurance Head On

Insurance is one of those necessary evils that everyone needs to have to afford their health care but often is confusing or hard to deal with in life.  Talking with your insurance company may seem like an insurmountable task, but that is not the case.  It just takes a little persistence and a lot of patience.

 

Chapter 1: Evaluate Your Insurance to See If It Fits Your Current Needs

Not only should you evaluate your doctors, but you can also evaluate your insurance to make sure that it fits your current needs.  Think about if many of your prescriptions are not being covered, changes have been made to your coverage that you don’t like or other things you are unhappy about in general with your current plan.  These may all be signs that your insurance is just not good enough for you anymore, and that it’s time to shop around to find a better plan.  There are options with Medicare, Medicaid, private health insurance companies, and veterans plans that you can evaluate to see which you qualify for and what will work best for your current situation.

 

Chapter 2: Research Other Insurance Companies Before Open Enrollment Periods

The first step that you need to take when evaluating new insurance options open to you is to research the different options and companies.  You may even find that your current insurance company has a different plan that will be a better fit for your current needs.  Some of the things that you will want to research include whether or not your current doctors take this new plan, what prescriptions will be covered under it, and how will your out of pocket costs change?  Open enrollment for 2016 has already ended, but getting a head start for next year can be advantageous because it gives you plenty of time to do extensive research.  Just be sure to ask whether or not the insurance company may be planning any changes before the new enrollment period.  Comparing plans is a great idea, and may give you a list of a few that you like just in case there are any of those pesky changes.

 

Chapter 3: Is Ancillary Insurance Right For You?

If your health insurance plan does not cover everything that you want, you can look into purchasing ancillary insurance if you don’t already have coverage in these areas. Dental insurance is often a great idea because your health insurance company may only cover certain dental procedures. Dentures, partials or keeping up your own teeth can help your current well-being greatly.  Not being comfortable enough to eat can cause health problems all of its own.

The same is true of vision insurance.  Very few health insurance companies cover anything when it comes to needing new glasses or bifocals.  For those who have eye health problems like cataracts and glaucoma, you should speak with your healthcare insurance first about what is covered, and then try to fill any gaps with your ancillary vision insurance, if possible.

You may even want to look at other options in ancillary insurance, such as long-term care or home care to see if there are any plans that you qualify for that meet your needs now or protect yourself and your family in case you need it in the future.

 

Chapter 4: Tips on Dealing with your Insurance Company

You would probably rather go to the dentist than have to call your insurance company, especially if it is about a pending or denied claim.  There are some things that you can do that can greatly help you when it comes time to pick up the phone.  First, try to call when they are having a lower volume of callers.  Mondays are often pretty busy days since everyone has been waiting the weekend to finally call.  This may not be easy to determine for other days, but some companies will give you an idea through a phone message or message on your correspondence about the best times to call.

You should also have all your information with you when you make the call.  Keep your insurance card, any information about what you are calling about, and any documentation that they have sent you about your plan or claims.  This will make it easy to refer to when finally getting a live person to speak with about your issue.

When dealing with something that has been denied or some other issue, you should get all the information that you can about how to appeal the denial or deal with the issue.  This can help you to reverse that denial, and get your insurance to cover this item.

 

SECTION V: Managing Other Healthcare Providers

You may be using other healthcare providers, such as case workers or chiropractors, and these are resources you can manage, as well.  Talk with them about any questions or concerns that you may have about how they treat you and how their work interacts with what your other providers are doing for you.

 

Chapter 1: Evaluate Your Current Needs When it Comes to Other Healthcare Providers

As with doctors and insurance companies, make sure that these other healthcare providers are meeting your needs.  If they are not, think about moving to one that might be more appropriate for your needs.

For those that do not currently have a case manager or other healthcare providers, you may want to look into how these roles may benefit you in your life.  Many insurance companies want you to get the best care possible with preventative care and other programs because that may cut their expenses for you down the road.  To this end, they may assign you a case manager or case worker to help you with managing your health care needs.  Take advantage of this service if it is available to you because they will often help be your advocate and speak on your behalf with great experience dealing with the medical community.

 

Chapter 2: Does Your Insurance Cover Them?

Your current insurance coverage may impact what other healthcare providers you can have access to for your care, as they may be too cost prohibitive to afford without help.  Talk with your insurance company about your coverage to get the full picture of what you can do without help.

Then, it may be time for you to look into other sources of assistance.  Don’t be afraid to ask for help in affording the things that you need that may help to improve your quality of life.  Not only are their federal programs available to assist seniors, but there are also state and local programs that look to enrich the lives of seniors.  You may find that you can get meals delivered or a home health aide to visit several times a week through these types of programs where you are not responsible for bearing the cost.  Contact your local council of aging or other senior advocate groups in your area.

 

SECTION VI: Pulling it All Together

Your health is important, and the healthcare resources that you have access to can be managed by you.  It is up to you to be your own advocate, so the time is now to start pulling this information all together in a way that will help you to achieve a better health care outlook for yourself.

 

Chapter 1: Help Others Help You by Formulating a Plan For Managing Your Health Care and Keeping an Updated Medical File

It is wonderful that you have decided to do this for yourself and take charge of your health.  You also need to be able to help others help you by creating a plan that is going to inform them of your current health care needs and provide them an updated medical file.  You never know when this information may come in handy, so having it around is a good idea.  All of the research and tools discussed in this guide can be put together into a file for your reference and your loved ones.  It can be helpful to use online tools to create your file and keep a hard copy, but a folder or file box would work just as well.  Not only do you need to let others know about your health care plans, but you also need to let them know where they can find this information.  Emergencies and accidents are never planned, so being prepared is the best way to face them head on.

 

Chapter 2: A Special Note to Caregivers

The information provided in this guide is not only for seniors but also for their loved ones, especially those that help provide care to their parents or other relatives.  You can and should take a more active role in managing the health care of the seniors in your life.  Just because you are not the patient doesn’t mean that you don’t have any rights when it comes to the health and wellbeing of your loved one, especially if have been granted power of attorney.  If you feel that you are not getting the help you need, or are unsure about your rights with the privacy laws, HIPAA.

You should also note of keeping records as you may be the one that had an emergency or accident that causes another family member or friend to have to step up to the plate for providing care to senior loved ones.  Knowing prescription routines or when doctor appointments are coming up will be helpful information in just such a circumstance.

 

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*This blog was first published here: Sunshine Retirement Living