August 6th, 2016

Health Insurance Forecast for 2017– Are YOU Prepared?

Hello, Friends!

 

Are you ready for health insurance news for NEXT year??   Sit, get cawfee, or a cocktail and let’s tawk!

 

This interesting article from the NY Times and this one from the Free Beacon each have loads of important info, but here’s the gist….

 

The SAME news: the NEXT open enrollment period will be 11/1/16 through 1/31/17.

 

The HAPPY news: Obamacare will be rating health insurance plans based on how many doctors and hospitals are in their networks.  BUT (as I am your interpreter of bulls*#$) this doesn’t necessarily mean that doctor networks are going to improve for individual plans.  It just means there’s more transparency for you to make informed choices.

 

The PHEW! news: there’s a new thing next year called “continuity of care.”   What do you do if your doc leaves your network?  Often they leave or get dropped from the network without any heads up to YOU.  BUT in 2017, if you’re in an “active course of treatment,” you’ll be able to continue seeing the doctor if they leave the network.

 

The BAD news: out-of-pocket maximums are going up.  WAY UP!  In some states, they’ll increase from $6500 to $7150 for individuals, and from $13,000 to $14,300 for a family.

 

The YUCKY news: The Beacon article anticipates that deductibles in most states will see increases , too.

 

The WORST news: hold on to something…  premium increases are on the horizon for 2017.

 

The more you know, the more prepared you’ll be for 2017.…

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August 3rd, 2016

“What’s Up, Doc?” Blog Series Part 9: The Doorknob Moment… and Other Missed Opportunities

Welcome back to our series, “What’s Up, Doc?”  You can check out the first, second, third, fourth, fifth, sixth, seventh, or eighth parts by clicking the hyperlinks to get up to speed.  And now, “The Doorknob Moment… and Other Missed Opportunities.”

 

  1. Be your own team!  Prepare in advance for your visit.   Patients who take a more active role in their medical care have better physiological improvement.  Remember, this is a TEAM effort between you and the doctor… with you as the Team Captain!
  2. Ask your most important FAQs first!   Don’t wait until you’re dressed and leaving the office!  They say in psychotherapy the most impactful part of the session is usually the last 5 minutes.  Don’t take that approach with your medical doctor or you could miss talking about some important info.
  3. This tip is for the fellas:  speak up!  Don’t be macho, tell the truth.  If something is ailing you, it’s better for your doctor to know so she can help.   This visit is not the place to put on a brave face.    Statistically, women are better than men at asking questions about their medical issues.  Not that we’re better or anything (wink, wink), we just go to the doctor more often so we have more practice.
  4. ASK if the doctor will communicate by e-mail.   Often e-mails become a valuable part of your chart.   If you happen to forget to ask an important FAQ or need further clarification, having a doctor who uses technology is critical!
  5. If the doctor doesn’t use email, find out the easiest way to communicate with her after the visit… phone, fax, carrier pigeon, smoke signals?    For example, does she return phone calls after normal office hours?  What about in real emergencies?

 

Look at how smart …

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July 27th, 2016

“What’s Up, Doc?” Blog Series Part 8: A Cure For What Ails You

Hello again, my avid readers.  Hugs for reading the first, second, third, fourth, fifth, sixth, and seventh of our series, “What’s Up, Doc?”

 

Last time, we left you sitting on the slab as the doctor came into the room.   And now a segment we call “A Cure for What Ails You” and is a continuation of advice from last week on what to do once you have their ear.

 

First and foremost, I like the concept that the doctor works FOR YOU!   Not the other way ‘round.   You are paying that person… she works for you!   You deserve her time and FULL attention.   Remember, you get a vote.   And not just any vote.. you get THE vote on how things proceed!!

 

  1. If you need tests, remind the doctor to use ONLY an in-network lab.
  2. If you need meds, ask if the generic is available.   YOU control how you spend your money!  The docs generally don’t think twice about prescribing expensive brand name drugs.
  3. Did the doctor advise seeing a specialist?  Ask for their IN-network referrals for a trusted doc before you leave.   But it’s still up to YOU to verify that the new doc is IN-network!
  4. If you need a follow-up visit, make the appointment before you leave!
  5. Remember to request a copy of the chart notes from today’s visit.
  6. ASK if the doctor will communicate by e-mail.   Often e-mails become a valuable part of your chart.

 

Who is your fave doc?  What have they done that makes them your fave?  Always love the shares from friends of The Insurance Mom.…

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July 20th, 2016

“What’s Up, Doc?” Blog Series Part 7: The Doctor is in! Now What?!

Look at you, friend of The Insurance Mom!  You’ve learned so much from our first, second, third, fourth, fifth, and sixth parts of our series, “What’s Up, Doc?” Don’t you feel well-informed and powerful!?
Here’s the next revelation, “The Doctor is In!  Now What?”

 

  1. Remind Doc Hollywood of any important medical history.   Do NOT assume they remember everything about you.  If you’re seeing this doctor for the first time give a brief summary of important medical history.
  2. As I mentioned in the second part of our series, always have a current copy of your medical records.   Before seeing a new doc for the first time, email a copy of your chart FIRST.    Hopefully, this will get your new doc up to speed before you get there.
  3. If you’re there for a physical (aka check-up, aka preventive care), remind the doctor that’s the ONLY purpose for your visit.    I want YOU to give explicit permission to the doc if she’s going to do additional tests or treatments that are NOT included in your free physical.  The Insurance Mom also recommends referencing this website which lists all of the stuff that has to  be covered by your insurance (it’s part of the Affordable Care Act!)… so you know your rights!
  4. Ask LOTS of FAQs.   There is always another question to ask!   So ASKAsk for clarification if you need it.  Ask the doctor WHY she is recommending this particular course of treatment or prescription.  Ask about side-effects.  Ask about likely outcomes.    Ask what alternative options may be available.   Just because a doctor makes a suggestion, doesn’t mean it’s a recommendation… or the best recommendation.

Thanks for following along to our virtual tour of the doctor’s office!  Now, talk to me.  Share your funny / interesting …

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July 13th, 2016

“What’s Up, Doc?” Blog Series Part 6: Cold and Alone, Wearing Paper… Make the Most of the Exam Room

You get a gold star for adult-ing, my friends!  Thank you for tuning in to “Cold and Alone, Wearing Paper: Make the Most of the Exam Room.”  Check out the first, second, third, fourth and fifth parts of our series, “What’s Up, Doc?” to get caught up to speed!

 

OK, you’re finally in the exam room.  While you’re shivering in the paper gown and bored of looking at Highlights Magazine, contemplate how you can get the most bang for your buck.

 

  1. Think of the most important thing you’re concerned about for THIS visit.   Start with this topic!   Narrow down the focus so you can use the doctor’s time to your advantage.
  2. Studies show that a doctor stops actively listening after about 30 seconds before she starts taking notes or typing.   I like to make sure the doctor is looking at me and having a dialogue before she starts charting her impressions!
  3. Remember that list of important questions you made before the visit?  Now’s the time to whip it out!
  4. Did your friend come with you?  Remind them what you’d like to accomplish.  And buy them a Starbucks when you leave. 🙂  Don’t have a BFF available to attend the visit?  Use the voice memo app on your phone.   Technology is great when we use it, am I right?
  5. Heads-up… before you leave ANY doctor’s appointment, ask for a copy of that day’s chart notes for your records!   I’ve never had a doc refuse my request.
  6. Be absolutely sure that what the doc wrote in your chart is REALLY what you talked about and reflects the tests or treatments or medications to which you’ve explicitly
  7. Correct any mistakes in an email and fax to the doctor!

 

Learning lots?  Now teach me what you know!  I …

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July 6th, 2016

“What’s Up, Doc?” Blog Series Part 5: Make the Most of Your Waiting Room Time

OK, family!  You’re in it to win it.  Thanks for tuning in for our first, second,  third, and fourth parts of our blog series, “What’s Up, Doc?”   We’re giving you tips starting from the first little inkling of the need to see a doctor to a diagnosis.

 

Today, we’re on our fifth part in our series, “Make the Most of Your Waiting Room Time.”  You’ve arrived at the doctor’s office and they’ve taken your name.  So now what, Insurance Mom?  Here you go…

 

  1. On the day of your appointment, call and ask if the doctor is running on time.  If they’re running late, sometimes the receptionist can give you a heads up that you can arrive a bit later.  Less waiting in waiting rooms when you’re feeling under the weather!
  2. Look at your insurance ID card so you know what your IN-network office visit co-pay is.    Remember, that the office visit co-pay is what the doctor charges you just for showing up!   Sometimes the office visit fee is all you’ll pay for a consult.  But sometimes, you will also pay for any medical services the doctor does to/for you.
  3. On ALL plans that comply with the ACA (ObamaCare), you get one FREE check-up a year with an IN-network provider – NO co-pays required!.    If you’re seeing the doc for your annual physical, know ahead of time exactly WHAT services are covered.   And make sure you do not get charged for the visit.
  4. For a list of what’s covered, see this webpage for guidelines.   Take the list with you so you can show it to the doctor.   You’d be surprised how much the doctors don’t know about the ACA!!

 

Please keep me posted on any thoughts or questions that come up while reading.  …

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June 29th, 2016

“What’s Up, Doc?” Blog Series Part 4: Homework to Do Before Your Appointment!

Welcome back to our blogginess, “What’s Up, Doc?” You can find the first, second, and third parts in our series with those hyperlinks, hopefully giving you a Grey’s Anatomy to getting good healthcare.  😉

 

Today, we hit “Homework to Do Before Your Appointment!”

 

  1. Always have a current copy of your medical records.    Heads-up… before you leave ANY doctor’s appointment, ask for a copy of that day’s chart notes for your records!   I’ve never had a doc refuse my request.
  2. If you’re going to a new doc for the first time, email or fax a copy of your chart FIRST.    Hopefully, this will get your new doc up to speed before you get there.
  3. Your “go bag” should include a list of current medications and a record of any recent visits to other docs, why you went, and what happened.
  4. Write down your questions before the visit.   It’s easy to forget when you’re not feeling well!  Make a short list of other concerns and take it with you.   You can always come back to talk about other stuff, but what was the primary cause of making this appointment?    Stay focused!
  5. Ask  a friend to go with you.   It’s good to have a BFF in the room to write down what the doctor said… and to ask important questions which may not occur to you.   And it’s good to have loving support in the room, too, especially when you’re feeling scared!    “Selective hearing” is real and it happens!

 

Tune in next time for what to do you when you finally get to your appointment.

 

As always, I love hearing from my peeps.  Share your tips and tricks with me!…

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June 22nd, 2016

“What’s Up, Doc?” Blog Series Part 3: Let’s Make an Appointment!

Hello, my lovely readers!  Welcome back to our on-going series, “What’s Up, Doc?” I’m your host, The Insurance Mom.

 

You can read about finding a good doc HERE and about what to do before scheduling your appointment HERE.   Now, “Let’s Make an Appointment!”

 

  1. Doctor’s offices are busier than ever.   Schedule an appointment as soon as you know you’ll need a follow-up visit or as soon you’re feeling icky.
  2. Or skip the doctor and go right to an IN-network urgent care center.
  3. If it’s a simple medical issue, you can also try LiveHealthOnline.com.  You can video chat 24/7 with a board-certified doctor (even a therapist!).  Sometimes they can even diagnose and prescribe meds!  Use code HEALTHYWOMEN for a free first visit.  Men, I wasn’t able to find one for you so use the code at your karmic risk. 🙂
  4. If you read our first posts, you already know if the doctor is in- or out-of-network.  If the doctor is OUT-of-network (and this the only doc you want to see), ask what the cash price is.  If you don’t faint when they tell you, say you’d love to keep doing business with them but the doctor is out-of-network for your plan.  Suggest that they give you a cash   See what they say!  Never hurts to ask, right?

 

Be a good negotiator, be your own best advocate.   It’s YOUR money, you have the control, not the receptionist!

 

Let me know, audience… how do YOU fare at the doctor’s office?  Share with me!…

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June 15th, 2016

“What’s Up, Doc?” Blog Series Part 2: What Do Before Your Visit

Welcome back, folks!  Thanks for following our series, “What’s Up, Doc?”

 

You’ve read the first part in our series, “How Do I Find a Doctor?”  and you’ve found a doctor you like.  Now let’s dive into the visit.    What to do before you schedule your appointment.

 

  1. Make absolutely SURE that your doctor is IN-network on your plan BEFORE your visit.  If you haven’t been in a while, it’s possible things have changed.   Search the provider directory at your insurance company’s website.
  2. If they are IN-network, you will probably have a co-pay for the office visit.   If you don’t remember how much your copay will be, check your ID card. The co-pays for primary care and specialists should be listed right on the front!
  3. Know what a co-pay means!  Remember… the office visit fee co-pay is what the doc charges you just for showing up and reading old magazines!   They call it the “consultation.”   Sometimes the office visit co-pay is all you’ll pay.  But sometimes, you will also pay for any medical services the doctor does to/for you.
  4. Register at your insurance company’s website.  There are lots of cool tools available… including a whole run down of your insurance benefits.
  5. Download a copy of your benefits into your phone (let it be smart for you!)     Know more than the receptionist about your plan… stay in control of your money!

 

As always, please keep me posted on your rolling thoughts, tips, tricks, and FAQ’s!  I want to hear from YOU!…

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June 8th, 2016

“What’s Up, Doc?” Blog Series Part 1: How to Find a Doctor

Wanna get more out of your visit with the doctor?  Here’s a great 2005 LA Times article coupled with expertise from The Insurance Mom herself.  Despite the new world order created by the Affordable Care Act, this info will still help you!

 

Watch for our new multi-part blog series, “What’s Up, Doc?” We’ll be sharing some tips & tricks about how find a good doc, how to talk to your doc, how to get the most out of your health insurance and, ultimately, how to feel like your doc really “hears” you.

 

First steps first…. getting a doctor you know and trust.  The Congressional Quarterly recently shared a report from the CDC which says up to 26.7 % of Americans may have access to healthcare now, but they don’t have a “usual place for medical care.”    They “haven’t found the right provider or been diligent about making appointments to see them.”  With more people using insurance now more than ever, doctor’s offices are busy and only taking certain types of insurance.    We call that “rationed health care.”

 

You don’t want Dr. Do-little, so now it’s time to research, research, research!  You do it for the best new sushi bar, or best deal on contractors and best prices for a car, why not with your doctors?

 

  1. Call The Insurance Mom.  She has loads of recs for docs in the LA area.
  2. Search your insurance company website for doctors in your immediate area.   Remember… IN-network means oodles of money-saving!
  3. Compare that list of IN-network docs to Yelp OR HealthGrades or RateMD’s.
  4. Don’t wait until you’re sick to get in with a doc.  Use a check-up as a good intro to meet & greet your new doctor (that way if/when you get sick you have a familiar face at
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