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January 23, 2014 at 3:13 PMComments: 0 Faves: 0

New Healthcare Policy? Get The Most Out Of It With These Four Tips

By Jeffrey VanWingen M.D. More Blogs by This Author

Do you remember Y2K? 

It was the turning of a new millennium. Fears circulated that a unforeseen glitch would disable computers, rendering them useless and the hype built until the moment of reckoning, but as we passed into the new millennium, Y2K was soon forgotten. It was an issue of a past era. This year we had another deadline, not quite so epic threatening as a global computer shutdown, but rather one of health insurance mandates and imposed changes in our healthcare system.  Americans were brought to a point of decision: secure health insurance or face tax penalties? This point, January 1st, was a couple of weeks ago and many now have new health insurance policies. Are you among them? Unsure of how to use it?

Let's talk about healthcare planning and use in 2014. 

1. Know Your Rules and Entitlements

To get the most out of a health insurance policy, it helps to understand how that policy was formed. Insurance companies are not about gambling; they employ highly-skilled strategists to formulate a financially sound benefit plan given a predictable set of risks.

As a policy owner, you presented the risks and they generated the cost and as a consumer, use of those policy benefits is your task. Fortunately, most insurance companies know that use of preventative services saves them healthcare expenditures in the end. If your policy provides for preventative services such as a yearly physical and screening tests, I encourage you to get them!

The other issue to consider with insurance policies is the coverage. Typically, policies have higher out of pocket costs for care with specialists or emergency care. For this reason, it is best to enroll yourself with a primary care doctor who is willing to see you when needed and take care of most needs without the need of specialty care. 

2. Ask Questions

Healthcare is expensive. In the past, a "whatever goes" mentality prevailed with healthcare usage. Now, with shared cost between patient and insurance, the stakes seem higher. For this reason, it is important to:

  • question your healthcare provider about whether all tests and procedures are really necessary
  • ask about prices before agreeing to anything
  • see if there are any possible alternatives to consider

For instance, where it may have been the norm to order every test needed at once, it may be more reasonable to order tests more sequentially or progressively now. 

2. Select a Doctor That Really Works for You

Today's more educated healthcare consumers are actually strengthening the relationship between patient and healthcare provider, but the relationship had been muddied with confusion as to just who was serving who.

Are patient serving doctors?

Are doctors serving insurance companies?

Are doctors serving patients?

To be clear, though patients are consumers who purchase a product provided by the insurance companies, it should be doctors who work for patients. If you suspect any other type of work flow, it's time to find another doctor.

3. Take a Proactive Approach to Your Health

It probably goes without saying, but now is as important as ever to take care of your health.  Better health means less need for healthcare services - a win-win situation for both you and your health insurance company, but with the coming changes in health insurance (such as new health savings accounts) this may even mean more money back in your pocket! To prevent unnecessary health costs and see that health saving return, eat a proper diet, exercise and get enough sleep - the essential triad of good health.

4. Keep Records of Your Healthcare Expenses and Use

As a consumer, you may have chosen between a number of policy options - traditional plan, high deductible plan, health savings account just to name a few. Even employees with employer-provided plans are often given choices now for coverage and this allows for some strategy on your part. Plan tracking is a prime example.

By keeping records of your healthcare expenses and use, you can optimize and better inform your choice in the coming year. Did you pay for something that you did not use?  Did you have a large expenditure that would have been covered on a different plan?  These are important questions to ask when considering the type of policy you'll enroll in for the coming year.

Healthcare and health insurance can be a pricey and confusing system, but with a little know-how you can optimize your position in the changing landscape. Learn what you're entitled to, select a good doctor that will work for you, ask questions, take a  proactive health approach, and keep records. All these things will ensure you're getting the most out of your insurance policy.

Live...and live well! 

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