There will be some news on treatment moving forward in the coming days, but for now, I wanted to share some insights I am gaining on the healthcare system that I hope everyone can benefit from, no matter what might bring you to a doctor's office.
Meet your new PCP
As I continue my treatments for Leukemia, many questions arise
while interacting with the health care system. How will the medical
professionals share information about me? When there are multiple
treatment options, who will decide which is best? How does my medical
insurance affect my treatment choices? I realized that I must take the
lead in managing my own health care, and you should too. You are now your
own PCP - Primary Care Person.
Personal Health Records
Today’s health care system is modular. Hospitals, doctors,
specialists, and testing centers are all set up as separate businesses and
rarely share information. There is currently no universal electronic
medical record system so you must be responsible for the transfer of knowledge
between them. My first, and most important, recommendation is to
starting keeping your own health binder that contains all of your health
information including medications, tests, shots, procedures, and even frequent
notes about your weight, appetite, and how you feel. People move, doctors
retire, and an emergent situation may thrust you into a health care setting
where a caregiver must make decisions for you. It will provide you peace
of mind to know that it’s all in one spot.
Doctors
In the past, Doctors were the center of the health care universe
and their word was accepted as law. Moving forward, you must place
yourself at the center and realize that there are many treatment options out
there for you, but you must explore them, ask questions and decide for yourself,
which is best.
I have an oncologist who has told me that I only need to
complete my chemotherapy and I should remain in remission. Then I
consulted a bone marrow transplant doctor who said that I would eventually
relapse without a bone marrow transplant. How does a layperson resolve
this conflict? You have to seek out multiple opinions. In my case,
I went to the Moffitt Center in Tampa to get a third opinion from an oncologist
there.
Do you need surgery or can you rehab with physical
therapy? Should you go to your local hospital or travel to a specialized
center? Do you take more pills or change your diet? You must ask
questions and find the best treatment option for you.
Insurance
You need to become intimately familiar with your insurance
coverage. Insurance companies modify their coverage each year and most
changes can go unnoticed. It’s better to stay on top of these changes
before getting into a health care situation. You need to understand
deductibles, prescription coverage, total out of pocket maximum, and hospital
verses outpatient coverage. Not knowing these answers can cost you big
down the road. One of the benefits of the Affordable Care Act is that you
can shop your coverage freely to meet your changing needs.
When undergoing tests, it’s easy to assume that they’re all
covered by insurance. Is your test still covered when you walk across the
street? Will there be another co-pay? Is the test necessary?
How much will the test cost? These are all questions that most people do
not ask, but ones that we will all have to as we move forward.
You also need to get educated and involved on the billing
process once you’ve received care. Medical providers have their standard
prices for services, which no one really pays. They submit these fees to
the insurance provider who re-prices these services down to pre-negotiated
rates, typically 50%-60% lower. Then they decide if your coverage will
apply to these charges and if so pay the appropriate amount. You may be
left with a co-pay or uncovered balance that comes out of pocket. Don’t
be afraid to ask for discounts from your health care providers.
My college professor always said, “If you don’t have your health, you don’t
have nothing!” You must make it a priority to take on the role of primary
care person for your own health and anyone to whom you are a caregiver.
It’s going to be work, but
you’re worth it.
