(This article was also published on Elephant Journal at http://www.elephantjournal.com/2012/11/tips-for-healthcare-navigation-dr-ariele-foster/)
It’s nearly Thanksgiving, and I am counting my blessings.
Having decent health insurance is certainly one of them. Another sometimes-blessing is having insider know-how about the health industry.
I’m a physical therapist (and yoga teacher) with lots of patients. I work for a big hospital network that provides good benefits to employees. But I spent my 20′s as a struggling yoga teacher, often financially stressed and paying out of pocket for my own health care with less-than-stellar health insurance.
It occurred to me that in this time of economic uncertainty and challenge, I could share some healthcare navigation tips. These are particularly relevant if you are also blessed to have health insurance, and if you appreciate money-saving advice.
In a seven weeks, a new year begins, and so do many insurance plans. That deductible that annoyed you late last winter starts from zero all over again*, with perhaps a higher threshold than before. Your co-payments (per visit charges) may increase. Many of my patients have copays as high as $45, and it breaks my heart when someone who is in need tells me she can’t afford physical therapy.
Doctors of all sorts are frustrated. It’s possible your doc might opt our of accepting your type of insurance as the contract year ends. It’s possible that your health insurance will change reimbursement rules for seeing a provider that is out of network.
This is not theory or paranoia. The percent of health care costs that are paid by consumers has risen steadily for years.
Adding to the impetus to address your health issues now is your flexible spending account,should you have one. If you do, you’ve paid in advance for at least some of your direct healthcare costs.
It’s very tricky to guess what your out-of-pocket expenses will be for the year ahead: I know I have not spent all of my FSA yet (usually we have until mid-March to complete your spending). If you don’t spend it by the deadline, you lose it completely.
Please take a moment now to consider what healthcare needs you have. Maybe you have questions or concerns for health care professionals that have been brushed aside, to see if they go away. If your health insurance is looking less favorable to you in the new year, don’t forget that it often takes a month or more to get in to see a new doctor.** Call now. Set a reminder on your phone for the next workday. Or three. Research the best providers in your area now. Ask friends or on Facebook for suggestions.
If you have nagging back pain, muscle spasms, TMJ pain, poor balance from ankle sprains, consider setting up appointments with a trusted physical therapist ASAP. At my clinic, it can sometimes take two weeks to get an initial evaluation. For specialists, more. (We aim to spend a whole hour with you at your first visit). Physical therapy is typically a commitment: I tend to treat patients for four to six weeks at a time, usually twice a week. Some of the new patients I evaluate this week will continue to be in physical therapy into January, especially if they are out of town around the holidays. Call someone now. You may be surprised by how much physical therapy can help all sorts of conditions (including yoga injuries!).
I know it is a busy time of year. But this post is one about love. Love yourself, and please take care for yourself. It is the greatest gift you can give to those who love you.
If money is any obstacle between you and your health, if you have ever felt disgruntled by all the fees and extras you pay on top of your health insurance, be wise, be empowered about it and figure out what changes your health insurance will be making for the new year. If those changes are not in the favor of you as a customer, use what you have now. Let THAT be a fire under your butt to get the care you need and deserve NOW.
If your health insurance is robust and will be making no changes, if you feel fully healthy in no need of seeing a health care provider, count those among your many blessings this time of year.
P.S. This post is about practical advice that I would want to hear myself and is not self promotion (I am salaried, not paid by the patient or by how many patients want to see me whatsoever at all). However, should you need one, I would be more than happy to be your physical therapist. I work at 2021 K St NW (near Foggy Bottom and Farragut North) for National Rehabilitation Hospital’s outpatient network. We accept most types of health insurance, something many physical therapy sites don’t do. I weave yoga into my treatment sessions frequently, and always give you exercises to do at home. My regular hours are 9:30-5:30 M+W and 8-4pm T/Th/Fri. To reach the scheduling desk, please call (202) 466-9719.
* Not every health insurance plan has a deductible, but deductibles are very common.
** My apologies for not thinking of making this post earlier in the fall!