Things to Consider When You Are Trying to Choose the Right Healthcare Plan

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You’ve just started a new job, and it’s time to choose a new healthcare plan. Your employer is offering you several plans to choose from. Here are some things to consider when you are trying to choose the right healthcare plan when you are starting a new job.

Start by reviewing the features of each healthcare plan, and then base your decision on a side-by-side comparison of the features of each plan. Then choose the one that best fits your needs. Key factors to consider include deductibles and out-of-pocket costs, whether the plan includes a health savings account, your status as an employee, health insurance networks, your family status, and your age.

Deductibles and Out-of-Pocket Costs

A lot of words are thrown around when choosing and discussing healthcare plans, and it’s important to understand what they mean. A deductible is an amount defined by your insurance provider. It’s how much you pay for your healthcare services before your insurance provider steps in. If your deductible is $1,000, you’ll have to cover $1,000 of your medical expenses, and then you’ll most likely only pay a copay for those covered services and your insurance covers the rest.

Out-of-pocket costs include your deductible, and they also include the cost of all services that aren’t covered. It’s important to analyze the relationship between your new salary and the out-of-pocket costs you may have. Analyze what you’ll be able to afford if you have a medical emergency.

Health Savings Account

A Health Savings Account, or HSA, is a hybrid between a high-deductible health insurance and a tax-favored savings account. Benefits of an HSA include less expensive health insurance, tax-free withdrawals, and tax-deferred interest earnings. Plus, unused money in your HSA isn’t forfeited at the end of the year. It continues to grow! However, you may pay higher out-of-pocket costs at first.

Employee Status

Employees that are higher up on the “corporate chain” may be able to renegotiate presented healthcare plans. If you have a higher-paying or higher-status job, and you aren’t happy with your current options, try discussing other options with your company.

Health Insurance Networks

Some health insurance policies have networks and won’t cover services provided out-of-network. If you’ve got a preferred doctor or specialist you or your family sees, make sure they are in the network of the healthcare plan you’re thinking about. If not, you may want to either switch plans or find a new medical provider.

Family Status and Age

Your family status, and whether you are single, married, and/or a parent, all influence what healthcare plan you might choose. Your personal health also influences your choice. If you frequently visit the emergency room, are expecting or want to be expecting a child, or you have a planned surgery upcoming, you may want a plan that has higher premiums but better coverage. If you’re close to retirement age, you may want to look at insurance plans that benefit retirees.

For more informatoin on healthcare, follow the Avidity Medical Design blog. To enrolls in an online healthcare course, visit Avidity Medical Design Academy.

What Physicians Can Do To Fight The Rising Cost of Healthcare and Support Medical Necessity

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Everyone’s trying to tighten their belts lately, and the medical field is no exception. One way to fight the rising cost of healthcare and support medical necessity is with smart diagnoses, fewer unwarranted procedures, and a more open dialogue between doctor and patient. Here are some steps the physician can use to determine if a treatment is medically necessary:

  • Collect a complete medical history. Every medical exam has a portion of medical history Q&A to it, but patients sometimes forget a detail here or there. If you think that a few more facts about their past can change whether a procedure is done or not, then ask. Asking a few more questions to flush out the whole story can rising cost of healthcare and medical necessityenlighten you on what may really be going on.
  • Double check diagnosis. The human body reacts similarly to various problem, so symptoms can be present in a lot of differ diseases. Double checking your diagnosis for similar diseases and matching it up with your patient’s medical history can mean the difference between right diagnosis and misdiagnosis.
  • Ask if the procedures are necessary. Certain procedures are necessary, and others are just a precaution. An article Laurie Tarken released in Fitness Magazine noted in 2009, $325 billion of the nation’s $2.7 trillion annual health care bill went to unnecessary medical procedures. This explains why speciality physicians groups are calling on their members to stop reflexively calling for some 200 tests and procedures to be done. Instead, these physicians are being asked to consider the efficiency of the test, and look for more efficient methods to get a correct diagnosis or treatment.

To be fair, it’s not always possible to avoid asking for tests and procedures to be done, especially in specialities with a risk of high litigation. In that case, it may be possible to simply cut back on preventative measures, such as the annual physical exam to get our health checked out. For some people it may be necessary to get their health checked regularly, while others can go for years between exams without harm.

For example, Laura Esserman, M.D., a professor of surgery and radiology at the University of California, San Francisco and the U.S. Preventative Services Task Force say that you can get a blood test for total cholesterol and HDL every 5 years as long as the findings are normal, but blood pressure testing should be done every other year unless it’s higher than the recommended levels for the patient’s age and fitness level.

Gaining the confidence necessary to diagnosis and call for the correct procedures comes with great training and lots of practice. This could help physicians fight the rising costs of healthcare and medical necessity over time. If you’d like to talk about this, or anything else, please contact us.