2010 March

Choosing the Right Health Plan

With the recently passed health care reform legislation, millions of Americans will find themselves having to “purchase” health care coverage. Whether you’re getting coverage for the first time, evaluating Medicare options, shopping for individual insurance, or choosing a plan from options offered by your employer, the process can be complicated and confusing. Start by evaluating the following:

Your Budget

Even if you qualify for a subsidy, determine how much you can pay for health care on an annual basis. Questions to ask yourself:

Who will be on the plan? Just you? You and a spouse? What about children? The new bill allows for adult children up to age 26 to stay on a parent’s plan. This decision affects premium rates.
Which works better for you: a lower monthly premium with an upfront deductible or a higher premium with no upfront deductible?
What about co-pays? If you go to the doctor frequently, you might want a plan with lower co-pays, a higher monthly premium and little, to no, upfront deductible.
Think in terms of surgery and preventative care (physicals, colonoscopy, etc). Check the plan for out-of-pocket (meaning your dollars) costs for these services. Many benefit plans include preventative services. Explore this carefully as it could have significant impact when you need care.

The Network
Once you’ve determined budget issues, consider the network. Make a list of all the doctors and health care providers you and your covered family members have seen in the last 12 months. If you currently have coverage, register for and use the plan’s website to review your claims history. Using this information, assess your needs by answering these questions:

Do see certain primary care or specialty doctors on a regular basis?
Do you prefer a particular hospital?
Do you want to be able to obtain second opinions outside of your local area? If so, you might want a health plan that includes some level of coverage for non participating doctors.

When evaluating your needs, be sure to include health care professionals such as physical therapists, chiropractors or optometrists.

Next week Health Champion will explain how to evaluate benefit designs. If you have any questions — or issues you’d like covered — please leave a comment and we’ll address your concerns in an upcoming blog.

This is March: Where’s your Colonoscopy?

If you’re 50 or older, this message is for you: Have you had your colonoscopy yet?

If so, congratulations. If not, what are you waiting for?

We know. The very word produces a Yuck response: not a topic for polite conversation. Except if you or a loved one has been affected by colon cancer. And then you can’t talk about it enough.

March is Colorectal Cancer Month, a time to remind people about preventative health screenings. So, that’s what we’re doing. Urging. And reminding. And 50 is the target time, because the majority of cancers occur after that age.

Colon cancer — a cancer in the cells of the colon or large intestines — is the third most common cancer in the U.S. — affecting about 110,000 men and women each year. Add in rectal cancer (located at the end of the colon), there are approximately 150,000 new cases annually. It often starts as a small benign (noncancerous) clump of cells called polyps, common in adults and usually harmless. However, since most colorectal cancer begins as a polyp, removing them early is critical to preventing cancer.

People prone to developing colon cancer are those who:

eat a high fat diet

have a family history of colorectal cancer and polyps

have polyps detected during a colonoscopy

have a history of chronic ulcerative colitis.

Planning for Your Colonoscopy:

Check your insurance benefits-if you are over 50 most insurance plans will cover a screening colonoscopy

Be sure to check whether your insurance benefits also cover the procedure if you have a polyp or any other tissue removed for biopsy

Check with your doctor which of your medicines you can take the morning of your procedure

Plan on being home the day before with easy access to a bathroom

Line someone up to drive you home, as you will not be allowed to have the procedure otherwise

Plan to wear loose, comfortable clothing

Prepping for Your Colonoscopy:

The day before: Known as “the bowel prep,” this is the most challenging part of the procedure. You’ll clean out your bowels by drinking clear liquids and taking laxatives according to detailed instructions…

The day of the colonoscopy: Arrive for the procedure a little early to allow for paperwork. You’re given a light anesthesia. The doctor inserts a long, flexible, lighted tube called a colonoscope into the anus, guiding it through the rectum and into the colon. The scope inflates the large intestine with carbon dioxide gas to give the doctor a better view. A small camera mounted on the scope transmits images to a computer screen. If the doctor sees a polyp or unusual-looking tissue, it can be removed and later examined for signs of diseases. The procedure takes 30 to 60 minutes. When you wake up, you’ll feel groggy and hungry. And that’s it.

Caught early, colorectal cancer can be successfully treated.

So, what are you waiting for?

Advocating for Your Needs In Time of an Emergency

There’s probably no place you need an advocate more than in the emergency room, where your care — or that of a loved one — has been suddenly thrust into the hands of an anonymous staff. Here are some hints for making a difficult time more manageable.

Prepare for an Emergency:
For yourself and those in your care, gather the following information; keep everything in one safe, accessible place and bring it with you to the ER:

Insurance cards (or copies of all cards)
Copies Power-of-Attorney and Living Wills
Dates of birth and social security numbers
Current addresses and phone numbers
Current lists of all medications (all prescription, non-prescription, vitamins, herbs, and supplements) including doses and how often they are taken
Past and current medical histories, including surgeries, chronic illnesses, and injuries
List of allergies to drugs, foods, pets, and environmental toxins and reactions when exposed to them.
List of all doctors, including primary care physicians and all specialists
Notebook and pen

At the ER:

Take Notes. Keep a list of key details, including doctor’s name and contact info. Note names of people who enter the room, including time and purpose. Jot down questions you want to ask when the doctor or nurse returns.

Ask Questions. Learn the names and clinical position of everyone involved. Find out why tests are being administered, blood is being drawn, or you’re being given a particular medicine. Ask about side effects.

If you have allergies to drugs, find out if the medicine will be a problem. Ask questions until you fully understand the information.

Express Your Opinion. It’s okay to disagree. Listen to explanations and discuss your point of view. There may be alternatives. Explore your options.

Understand the discharge plan. This should be explained to you in detail. Be clear about follow-up, restrictions, or special care needed after returning home. If home care seems difficult, ask for help. Are there community resources? Will your insurance benefits provide for assistance?

Advocating for your needs can be difficult, especially if you’re the patient. Arrange in advance to have someone with you, if an emergency should occur, with permission to speak with the doctors — an advocate who serves as another pair of eyes and ears, to ask questions, and to take notes.

This will take some preparation, but it is well worth your time!

Is this an Emergency?

There are times when you know it’s an emergency and you’re off to the ER. You don’t fool around with chest pains, for instance (no taking chances that it’s just indigestion). Ditto for broken bones and deep cuts.

But what about those other times? You know them: the sense that something’s wrong, but you’re not sure how bad it really is. it always seems to happen over a weekend or during the evening, when the doctor’s office is closed. Waiting doesn’t feel right, but neither does rushing to the emergency room.

Call your doctor. Most physicians have an answering service for this purpose. Offer the following:

Your full name; that you’re a current patient, in active treatment.
The best way to reach you (provide both cell number and land line).
The reason for your call, emphasizing that, while it doesn’t seem like an emergency, it’s a matter of serious concern that can’t wait for office hours. Don’t be too explicit, as most folks who take messages have little clinical experience. Use phrases, such as:
- My new medication is making me ill
- I am experiencing several new symptoms
- My pain has increased over the last (number of) hours and I need to discuss a different approach

Find out who’s on call. Ask the service to contact the doctor on your behalf rather than waiting for him/her to call in for messages. Note the time of your call and ask to be called back after the service relays your concerns. This will give you a time frame and help relieve anxiety.

Don’t ever hesitate to seek help. Even over a weekend. Even when you’re not sure whether or not it’s an emergency.

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Choosing the Right Health Plan

This is March: Where’s your Colonoscopy?

Is this an Emergency?

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