Empowered Patients – Keeping Health Care Costs Down

“Up, Up, and Away!” is an eight-issue Superman story arc where Superman has lost his super powers.  As a result, Clark Kent (alter ego of Superman) uses his skills as a journalist to defend Metropolis from bad guys.  Slowly, Superman begins to regain his powers just in time to save the day.

Much like the title of the story arc, healthcare costs have continued to trend “up, up, and away” leaving many consumers feeling like they have lost their power to control the costs.  While we can’t fix the healthcare system by ourselves, there are steps that healthcare consumers can take to regain their power to become an empowered patient.

Dr. Carolyn McClanahan, a Medical Doctor turned CERTIFIED FINANCIAL PLANNER^TM professional, presented at the Financial Planning Associations NorCal conference about how to effectively use health insurance.  So how can you become an empowered patient?  Here are Dr. McClanahan’s recommended steps to becoming empowered and keeping your costs down:

• When making an initial appointment with a doctor:

• DO NOT ask “are you covered under my plan?” Many doctors accept all types of insurance, but they may not be considered a part of the network your insurance covers.
• Ask “Are you in my network?” to confirm that they will bill preferential rates based on your insurance coverage. Make sure to document who told you the answer.
• If having a surgery or procedure, make sure that both the doctor AND hospital are in your network. Many doctors are not in a network while the hospital may be.

• Get the right type of doctor:

• Avoid a paternalistic and information only doctor. Look for a doctor who will collaborate with you and answer your questions as they are the key to controlling your healthcare costs.

• Be prepared for your appointments

• Write out how you are doing, current symptoms, medication regimen, and your diet (if your medical problem is diet related).
• If you have complicated issues, ask for a longer appointment.
• Give the doctor your medical history.
• Write down the questions you want answered during your visit.

• If you are referred for testing, ask the following:

• “Is the testing facility in my network?”
• “Are the doctors evaluating the tests in my network?”
• “What do you want to learn from the test?”
• “How will the results change the approach of the treatment?” If the doctor cannot provide a clear answer, ask if the test is really necessary.

• If medication is ordered, ask the following:

• “Is this covered under my plan?”
• “Is there a cheaper version?”
• “What are the benefits and risks?”
• “How long will I need to take the medication?”
• “What are alternatives to the medication being prescribed?”
• At the pharmacy, ask for the cash price and if there are cheaper alternatives.
• Check out goodrx.com to compare cost of prescriptions.

• Improving your health

• Ask what you can do to improve your health situation.
• Doctors don’t always provide you with the education you need to improve diet related illnesses or home therapy to improve musculoskeletal problems. If they aren’t able to provide this education, ask for a referral to a nutritionist or physical therapist.

• Protect yourself

• Read your insurance company’s handbook to see what is covered.
• On your hospital paperwork, write that you will only allow in-network care and get a copy of the document.
• Document everything! Write down who you talked to and when you talked to them.  Most insurance companies are recording the conversations with their call center, and then you have the date/time to pull up if needed.
• Ask for the most cost-efficient way to receive your care as hospital services may sometimes be more expensive than independent services.
• Finally, if your doctor is not friendly to you being an empowered patient, ask them what they are doing to help change the healthcare system.

While we may not ever develop a super power, we can be like Superman’s alter ego Clark Kent and use our skills to ask the right questions and become a more empowered patient.  If CCMI can help you determine how your healthcare costs impact your long-term financial plan, give us a call to see how we can help or provide other resources that may be available to assist you.