Saturday, December 6, 2008
Gift For Women
I have just received 200 copies of the most exciting book to hit the market in recent times. The book is published by Wake Up Women, a division of WakeUpLive... Wake Up has published a number of best-selling, team-authored books (paperback). To describe the format of the books I would say is similar to "Chicken Soup for the Soul". However, this long awaited book is written by Women for Women as a guide to enhance your life and truly Live a Life You Love. There are approximately 50 co-authors (women) from around the world, of which I am privileged to have been invited to participate. Each short story presents "golden nuggets" that you can immediately apply to your life...a little something for everyone.
I am offering a special for the holidays. Price is reduced. $14.00 including shipping.
You can start at my home page to direct you to the order pages www.EZHealthCareOnline.com or go directly to the order pages www.ezhealthcareonline.com/wakeupwomenbookandfreebonus
You have really got to check this out before it's too late!
Friday, November 21, 2008
"Know" Surprises with Health Insurance Plans-HMO
The HMO (Health Maintenance Organization) in it's most strict time, placed heavy restrictions on the setting for care (hospital, MD office, home) as well as the cost. The concept was that an exclusive network of care providers was created by payers. The providers would accept deep discounts on their reimbursement in exchange for guaranteed steering of patients to them. The impact on you is that you MUST use providers within that network or you pay a much higher price. Additionally, each person was to have assisgned a "Primary Care Physician" who was considered the gatekeeper for directing what care you did receive, i.e. referral to specialists, etc. The philosophy is that there would be one person/physician that would be in a position to keep the pieces of your care coordinated. Did it work?? For the sake of discussion, no it did not. The ultimate result was that there was too many services, too few primary (family) doctors and too many specialists.
Ultimately, the Managed Care concept met too much resistance to actually contain costs. The care was still passed around to specialists and there was not much actual coordination of care...just control of care. Over time, care became more fragmented as new technologies and treatments continued to attract people to multiple specialists and increased the costs. It has become "Managed Cost resulting in Mangled Care".
The HMO still exists today, but really the only thing that resembles the original HMO is the network of contracted providers. You must use those providers or pay a higher cost. A primary physician is usually no longer required...why would it be...it didn't work anyway. In fact, the HMO doesn't really look all that different from other popular types of coverage plans such a PPO (Preferred Provider Organization). The KEY for you is to read your policy carefully...some items will be covered and some will not and circumstances may dictate whether care is approved. Let's be clear...the payors are not dictating whether you can receive certain care but whether they will pay for the care. That's another set of posts. In the meantime, stay Healthy and Happy. alice@EZHealthCareOnline.com http://www.ezhealthcareonline.com/
Sunday, November 16, 2008
"Know" Surprises with Health Insurance Plans
Today we are going to talk about the traditional "indemnity plan". This is what most people experienced in the early years of health insurance. Although it is not common to see this plan in today's healthcare market, it is good to understand how it works in order to help build the understanding of the evolution in health insurance. These plans are generally very simple. There is no restriction on the choice of doctor or hospital. For most encounters, you will pay a fixed percentage of the health bill. Common co-insurance (the part you pay) runs from 10% to 30% although it can be any number. Be sure you know what your co-insurance will be...a large bill could surprise you with a large part to pay.
On the other hand, the insurance company will pay either 90% or 70% respectively. While insurance companies have allways had contracts with health providers (as far as I know) to discount their services, the providers would increase their charges to off-set the discount. An example of this might look like this: a $500 dollar service would be discounted to $400. It would cost the insurance 80% ($320), cost you 20% ($80) and the provider collects the entire discounted $400. Then, so the provider can collect the total $500 for the same service the prices would be raised by 25%. The scenario then becomes 80% ($400) and 20% ($100) and the provider collects $500. Within these scnerios, note that your actual cost is higher. These scenarios have occured repeatedly through the years. The more the cost the more that the provider collected from you and the insurance company.
This cycle of increased pricing to off-set the insurance discounts, is in a big part the stimulus for creating other ways of negotiating and pay healthcare costs. That brings in the HMO and the term managed care. Refer back to the primary title of my blog as to how that played out. Our next discussion will be on HMO,
Saturday, November 8, 2008
Keep Your Dollars in Your Pocket: Bargain With Your Doctor
One last reminder. If you are negotiating with a facility (hospital, surgery center) do not pay your bill up front. You can save more money by examining the detailed bill. There are companies or people that can help you with that task. I can hook you up, give me a call. alice@EZHealthCareOnline.com www.EZHealthCareOnline.com
Thursday, October 30, 2008
Keep Your Dollars in Your Pocket- Managing a Chronic Illness
Save money on your healthcare by properly managing chronic conditions. Yes, I’m going to suggest that you actually spend some healthcare dollars. Let’s look at some statistics first:
- More than 40% of Americans have one or more chronic conditions and people with chronic conditions account for 75% of healthcare spending in this country according to a recent study published in Health Affairs.
- About 58 million non-elderly adults have at least one chronic condition.
- About 65% of people with chronic diseases are working age adults.
- Unfortunately, Americans with chronic conditions get the recommended care only 50% of the time and less than 50% have their disease satisfactorily controlled
- Only 50% of those with chronic conditions take their prescribed medication, and the cost of poor medication adherence is more than $100 billion annually in the US.
Let’s talk about these numbers for a minute. 58 million Americans have at least one chronic condition and we are not, or choose not to receive the recommended treatment. We will talk more about that recommended treatment at another time, but once again, the medication issue has surfaced. Over $100 billion is WOW! A lot of money! I can’t really comprehend that amount of money. But, once again it is critical that we take our medications as prescribed.
Let’s use the example of Congestive Heart Failure. There are multiple specific interventions crucial to managing heart failure in a controlled manner. One of those interventions will likely be to take medications that will keep excess fluid from building (a diuretic) and a medication to help the workload your heart must endure. If you wait until you are short of breath to take your diuretic, it then increases the workload on your already failing heart. It will likely contribute to a needed trip to the doctor or worse to the hospital ER. Do you get my point? By spending the money to buy your diuretic and then take it as prescribed, you are reducing the likelihood of a more expensive intervention. An additional benefit is you feel better and can enjoy more of life. If you cannot afford to purchase your medication, refer to one of my previous posts on that topic.
I hope you choose to live life to the fullest and not let a chronic illness take you down. Most of the time, it is a conscious decision. Until next time, stay happy and healthy. You can contact me at alice@EZHealthCareOnline.com
Friday, October 24, 2008
Some are Stopping Their Medications Due to the Economic DownTurn
I believe it is reasonable that expenses could be lowered by cutting out some medications…I don’t believe it should be undertaken lightly and certainly not without a joint plan with your physician. People are apparently stopping medications for high cholesterol, high blood pressure, etc. It seems to be primarily the drugs that do not produce a noticable affect such as that of pain pills. If you stop your pain pills you will feel bad therefore those will not likely be on your list to cut. If you stop your cholesterol medication, you probably don’t really notice a difference (at first).
Let’s talk about the consequences. Which is more cost effective: paying for the pill to keep your blood pressure under control or having a stroke, putting you in the hospital probably paralyzed, needing rehab and thus not being able to provide for your family or yourself. Sorry, but this is the harsh reality. If people stop taking the medications that are having a long-term benefit for your health, it will ultimately result in more severe illness and even higher medical expenses.
Below are my suggestions for approaching this dilemma:
1. Refer back to my previous post of ways to reduce the cost of your medications
2. Talk to your doctor about weaning from some of your medications
3. Many of the conditions being treated with pills can be controlled with diet and exercise. Examples are hypertension, diabetes (Type II) and high cholesterol.
4. DO NOT CHANGE YOUR PILLS WITHOUT TALKING TO YOUR DOCTOR!!!
5. Do not spread them out over a longer period or break them in half to take only half the prescribed treatment.
Please consider the longer term effects of your medications on yourself and your family. You do have options, please try them. Until next time, stay happy and healthy. alice@EZHealthCareOnline.com www.EZHealthCareOnline.com
Keep Your Dollars in Your Pocket (Part 2)
1. Generic drugs: When your doctor gives you a prescription, always ask to be sure there is a generic equivalent available. These are the same chemical structure, only much cheaper. Most meds that have been on the market for a while will have a generic counterpart. Beware of new medications on the market, they will usually be very pricey and no generic will be available.
2. Home delivery: For medications taken regularly, you can usually access your health plan's pharmacy benefit in which it can be delivered right to your front door. Besides saving on gas to frequent your favorite drug store, you can usually get three months at a time. To make it easier to switch to home delivery, call your doctor's office and ask the fax a prescription directly to home delivery pharmacy. They can then be scheduled on a regular basis so you will no longer have to remember to order your refill.
3. Drug List: Each health plan will usually have a list of drugs that are categorized into groups of which designate how much you will pay or how much the health plan will cover. It may be a difference in co-payment or some will not be covered at all. Take the list with you to your doctor and make sure any medications ordered are in the best category for your benefit i.e. your lowest cost.
4. Non-prescription drugs: Many medications that were once only available by prescription are now available without. They are usually less expensive than the same kind of drug by prescription. An example is the heartburn drug Prilosec. When purchased with a prescription it costs about $116 per month. The cost of a similar amount of the over-the-counter version is about $25. Be sure and check with your doctor if this could work for you.
5: Samples: One of the big ways that drug companies advertise their new drugs is directly with the physicians. In most doctor offices, there are frequent visits from drug salesmen. Most of the time, they will leave samples so the doctor can "try the drug" to see if it serves the purpose. Really, it keeps their drug in “top-of-mind” for prescribing. In some doctor offices, I have seen extensive amounts of sample medication...actual sample closets. If the doctor gives you a new prescription and there is not a generic ask if they have samples. I have been able to get a patient’s entire set of medications from samples. Unfortunately, with the economic situation of the past few years, even the drug companies have felt the pinch so it is somewhat more difficult to obtain samples in that quantity.
6. Different Drug: One of the things I usually include in suggestions for cost savings is to ask if there is a different medication that will accomplish the same thing, but be less expensive. There are times when the physician may not think about the cost of the drug. They will order the latest and greatest, or the one that the drug salesman recently spoke with them about. Whatever the reason, it does happen. Always ask if there is a less expensive drug. You can also talk to your pharmacist about alternative medications. Then your doctor will need to change your prescription.Hopefully these have been helpful tips to help you reduce your healthcare costs. Until next time, stay happy and healthy.www.EZHealthCareOnline.com alice@ezhealthcareonline.com
Keep Your Dollars in Your Pocket (Part 1)
The most prominate area of expense is with medication costs. The study indicated that while those <35 are in fact looking for ways to cut their medication costs but 1 in 5 say they do not know where to start. Only 3% of those over 55 answered the same.
In short, it appears there is an apathetic view of healthcare cost pervading the population...people either don't know where to start or simply feel it is a futile effort.
Well...let me tell you, it is not a futile effort! There are ways to cut your costs and streamline your care. Over the next few posts, I will be discussing some of those methods. Until then, stay healthy and happy.
Thursday, October 9, 2008
Can You Obtain Health Insurance?
Here's the link to the article: http://www.webmd.com/news/20071203/buying-health-insurance-on-your-own
In other words, if they do not have group coverage through the employer, it is difficult or near impossible to obtain it unless you are completely healthy. They told the story of a woman with Rheumatoid arthritis who lost her group insurance when her employer discontinued the plan. With her arthritis, the only thing that was keeping her from being completely disabled was a monthly injection of a medication costing $1400-$1700 per month. She has been turned down for most policy coverage or when accepted, it was to exclude any costs related to the rheumatoid arthritis.
I restate parts of the story to make a point. This situation is not an isolated one. I am fairly sure if I lost my group coverage, I would not be able to obtain coverage, or at least not anything I consider comprehensive and or affordable. In the above situation, she is actually considering not taking her injections (because of cost) until she is completely disabled again, then file for disability through the government systems. Now, is this what we want or need in a health care system? I think not, but it is not the fault of the insurance companies. I believe the insurance situation is a by-product of ever increasing costs of technology, drug research and development as well as the increase in the human life span. The attached link is to another article published on WebMD of items to consider and look for if you find yourself in the position of searching for health policy coverage.
It is extremely important that we demand of our legislators and the upcoming President of the US to implement a plan that will ensure every American is able to obtain health coverage regardless of current health conditions. We need to hold them responsible to first, implement a committee of health personnel and non-health care persons to identify what we actually do expect from our health care system. Then, do whatever it takes to find funding that will provide at least that basic requirement for every American. Now, I don't mean to imply that there is no personal financial responsibility.
As you can see, I am somewhat passionate about this topic. Due to that passion, I have provided some helpful resources on my web site (http://www.ezhealthcareonline.com/ ). I would also like to recommend a book recently published by a colleague. The book is "Healing Health Care" by Dr. Roger Howe. His analysis does give an interesting perspective of approaching a solution to this crisis...and yes, it is a crisis. That is my opinion.
Monday, October 6, 2008
National Case Management Week
The Case Managers are the ones who act as a central point of care coordination along with your physician. In cases where your primary physician cannot or does not act as a central coordination the Case Manager can assist in this manner. The basis of Case Management is to “manage” the case/care…your case. This does not mean we provide hands-on-care for your illnesses…your doctor should do that. We can assist you in pulling the different pieces of the healthcare puzzle together. This helps eliminate gaps in care, duplication in care by more than one physician and to help you understand your conditions to better self-manage. This is usually a Case Manager’s goal with you…to assist you to become more independent with your care and that includes providing education and resources. There are times when you may need the services of a case manager for a prolonged or extended amount of time.
My services at EZHealthCare include that of Community Based Case Management. If you would like to know more about how I can help YOU, please contact me at alice@EZHealthCareOnline.com or check my web site: www.EZHealthCareOnline.com
Saturday, October 4, 2008
Maintain Care Information Flow
Your consciousness of this is more important now than ever in the past. Most insurance plans today do not require a referral from a PCP for a specialist visit. All you need to do is make an appointment. If the specialist does not include your PCP with the findings of the examination and any tests, your PCP may never know of the specialist visit. There will be a gap in information and potentially in care. Ask the specialist to send a copy of the assessment and findings to your PCP. You may want to ask for a copy also. The days of the patient not being knowledgeable of the doctor's records are gone. You can then make sure your PCP does indeed have copies of your information.
Another area that needs your action to assure information flow is with your preventive care tests. An example is a mammogram. There is often no need for a physician referral for a yearly screening mammogram. If you do not identify the physicians to receive a report, your PCP may never know you had it done. Consider this aspect of your coordination of care any time you have a health care experience. You can always check with alice@ezhealthcareonline.com if you need assistance with any aspect of care flow.
Wednesday, October 1, 2008
Do You Need a Family Doctor?
Sunday, September 28, 2008
Health Insurance Application
No one wants that to happen, but that is how it works. My suggestion to you is to start a list now. Do this even if you don't think you will not need it. Going to a new physician, you will need to answer these type requests. Start your list now and every time something changes, update your list. Make a list of any medications you are taking or have taken in the past five years. Include even an antibiotic or sinus pill. Add the reason for taking each and the approximate dates. Do the same thing with any illnesses you may have or have had and any visits to a doctor.
Being proactive in keeping a personal health record now, will save you time and accuracy in the future. This gives you time to account for everything. As you remember something, add it to your log. Do this, and you will be prepared for the next time you are required to submit health information. You will find examples of blank logs on my web site: www.EZHealthCareOnline.com
Sunday, July 20, 2008
Increased Incidence of Two Cancer Types
I want to make everyone aware of some new statistics. It is not the most pleasant topic, but it is necessary. Cancer. The other day I discovered these statistics by the Americal Cancer Society. As we have all been shown many times before, the leading cancer for women is Breast Cancer and for men is Prostate cancer. Due to early detection and improved treatment, the incidence is decreasing. In other words, new cases of these cancers have decreased. However, for both men and women a leading type of cancer is colorectal cancer. I think it is very important to note various prevention and early detection procedures. An example of this is regular self-breast exam and yearly mammogram. In men it is a PSA blood test and rectal exam to check the prostate. These methods have decreased the incidence and mortality rate due to early detection. For early detection of colorectal cancer are checks for blood in the stool and a periodic colonoscopy.
A main point was made with both these charts is the fact that:
About 33% of the 559,650 estimated cancer deaths for 2007 are related to
- being over weight or obese
- physical inactivity or
- poor nutritian
Now, please look at the charts I have provided through this link to my web site. Obviously, preventive care is of ultimate importance.
http://www.ezhealthcareonline.com-a.googlepages.com/cancerstatistics
Thank you for visiting and I hope to see you again.
Alice
Sunday, April 13, 2008
Do You Have Chronic Back Pain?
I have back from a little time off. I've got a lot of stuff to share so I will get right to it.
If you have chronic back pain or muscle weakness, it may be caused by something you never would have thought...a lack of VitaminD. Yes, that's correct. A vitaminD deficiency. According to the authors of this article, we in the United States have contributed to this. There are many problems that can be a result of the lack of this vitamin. For one, in order for calcium to be absorbed for maintaining bone strength. This deficiency has been attributed to increase risk for several cancers...colon, breast, prostate, lung and skin cancers. It sould be easy to correct since the sun light is the main source of VitaminD. Since we have gone nuts to prevent any little piece of sun to hit our skin for fear of skin cancer we do not get the good and healthful aspects of the sun. The article mentions some studies that indicate the greatest risk for skin cancer seems to be fair colored skin. Of course, if we get many sunburns throughout our life, it can increase the risk.
Any way, I found this article to be very eye-opening because my physician has just identified that I have a deficiency. She has me on a gel capsule one time per week then to re-check in 3 months. The main thing that they seem to worry about is the lack of calcium absorption which will lead to brittle bones. I sure don't want that! But, I am interested in potential improvement in my achey and weak muscles and the low back pain. I don't think physicians are aware enough about other symptoms of VitaminD deficiency...We need to spread the word! The article gives information on home testing kits.
http://www.naturalnews.com/022997.html
I will keep you posted about my results!
I will also make available some a link to the article as well as other healthcare tips.
- Alice
Friday, January 25, 2008
Simplify Your Doctor Visits, Part 2
Write it down:
In addition to your questions also document your health history, it will help you in establishing a baseline for your new doctor. Below are suggested items to include in your list of questions:
- Document all your health conditions, when that condition developed and ended (if applicable), what type of treatment you have received and whether it is ongoing. This is a critical step to go with the medication list.
- Create a list to take with you to the doctor visit; write down all your questions, concerns, etc. In a subsequent post I will list several items that are critical to know in order to to adequately manage your healthcare.
- Take the list with you to the appointment (make a copy before you come).
- Depending on your condition, etc. may determine how to get your questions answered. If there are only a few questions, you may be able to ask them while you are with the doctor.
- Usually, your best action it to tell the nurse that brought you in that you have several questions for the doctor.
- Many times you can give the nurse the list and they will present it to the doctor prior to entering the room. This gives the doctor enough time to realize that he/she will need to spend a little more time. Additionally, they may be able to answer some of them prior to entering the exam room.
- You can use the information provided to search the internet for additional info.
- Keep up with that list of questions and answers so you can compare over time...at some point you may need to refer to it.
Eight steps to an efficient doctor's appointment. Of course, this would also be applicable for other types of healthcare professionals, for example Physical therapy, chiropractor, any of your specialists.
Once again, I have placed a template on my web site for your reference. www.ezhealthcareonline.com
I hope this helps you in some way. I know it has definitely helped me! Thanks for your time.
Alice
11 Steps to a Productive Doctor Visit
Here is my solution to both issues: Write it Down and keep it updated. Easy, right? Well, it does take some time on the front end, but saves you time on the backend. Let's start with your medication list...if your doctor is not completely informed about your current medications and your allergies, he could easily prescribe something that is not compatible with one or more current medications.
- Gather every medication you have, even any over the counter meds such as Advil, Prilosec, sinus pills, etc)
- Also count any herbal supplements.
- Sort them based on the reason you are taking them...if you are going to include meds you are not currently taking, be sure to note that.
- Write down all the information for each medication.
- Name of Drug - common name and generic name if applicable.
- Dosage of Drug - for example: 20 mg or 50mg.
- The route taken - by mouth or injection (for example: Insulin, injected)
- Reason you are taking this medication...this is very important!
- When was it first initiated?
- Include the ones that you just take periodically as needed, but be sure and state that on your record.
- Record all your allergies...even if it is just hay fever.
There you go. Eleven Steps to a Productive Doctor Visit, Part 1. I will place a log on my site that you can retrieve if you want to use it. That site is www.ezhealthcareonline.com
The next post will deal with communication with your doctor...be sure and tune in!
Alice