November 29, 2012

Tips for Healthcare Navigation. ~ Dr. Ariele Foster

I’m counting my blessings this holiday season.

Having decent health insurance is certainly one of them. Another sometimes-blessing is having insider know-how about the health industry.

I’m a physical therapist (and yoga teacher) with a full schedule of wonderful patients. I work for a big hospital network that provides good benefits to employees. But I spent my twenties as a struggling yoga teacher, often financially stressed and paying out of pocket for my own health care with less-than-stellar health insurance.

It occurred to me that in this time of economic uncertainty and challenge, that I could share some healthcare navigation tips. These are particularly relevant if you are also blessed to have health insurance, and if you appreciate money-saving advice.

A new year begins soon. So do many insurance plans. The deductible that annoyed you late last winter starts from zero all over again*, with perhaps a higher threshold than before. Your co-payments (per visit charges) may increase. Many of my patients have co-pays as high as $45, and it breaks my heart when someone who is in need tells me she can’t afford physical therapy.

Doctors of all sorts are frustrated. It’s possible your doc might opt our of accepting your type of insurance as the contract year ends. It’s possible that your health insurance will change reimbursement rules for seeing a provider that’s out of network.

This is not theory or paranoia. The percent of health care costs paid by consumers has risen steadily for years.

Adding to the impetus to address your health issues now is your flexible spending account (FSA), should you have one. If you do, you’ve paid in advance for at least some of your direct healthcare costs.

It’s very tricky to guess what your out-of-pocket expenses will be for the year ahead, but if you don’t spend your FSA “guesstimation” by the deadline (usually you have until mid-March to complete your spending), you lose it completely.

Please take a moment now to consider what healthcare needs you have. Maybe you have questions or concerns for health care professionals that have been brushed aside, to see if they go away.

If your health insurance is looking less favorable to you in the new year, don’t forget that it often takes a month or more to get in to see a new doctor.** Call now. Set a reminder on your phone for the next workday. Or three. Research the best providers in your area now. Ask friends or post your question on Facebook now for suggestions.

If you have nagging back pain, muscle spasms, TMJ pain, poor balance from ankle sprains, consider setting up appointments with a trusted physical therapist as soon as possible. At my clinic, it can sometimes take two weeks to get an initial evaluation. For specialists, more. (We aim to spend a whole hour with you at your first visit).

Physical therapy is typically a commitment: I tend to treat patients for four to six weeks at a time, usually twice a week. Some of the new patients I evaluate this week will continue to be in physical therapy into January, especially if they’re out of town around the holidays. Call someone now. You may be surprised by how much physical therapy can help all sorts of conditions (including yoga injuries!), and good physical therapists will give you homework (home exercises) to help you sustain relief and stay in top form.

I know it’s a busy time of year. But this post is one about love. Love yourself. Please take care for yourself. It’s the greatest gift you can give to those who love you.

If money is any obstacle between you and your health—if you’ve ever felt disgruntled by all the fees and extras you pay on top of your health insurance—be wise, be empowered about it and figure out what changes your health insurance will be making for the new year. If those changes are not in the favor of you as a customer, use what you have now. Let that be a fire under your butt to get the care you need and deserve now.

If your health insurance is robust and will be making no changes, if you feel fully healthy in no need of seeing a health care provider, count those among your many blessings this time of year.

* Not every health insurance plan has a deductible, but deductibles are very common.

** My apologies for not thinking of making this post earlier in the fall!

Dr. Ariele Foster, PT, DPT, E-RYT, practices physical therapy and teaches public and private yoga classes in Washington, DC. She has been teaching yoga since 2001, and decided to become a physical therapist after sustaining an injury through her yoga practice. Ariele is passionate about injury prevention and safely returning to asana (yoga poses) practice after injury, an anatomy review workshop series for yoga and movement teachers. She proud to be on the faculty of Embrace Yoga with Faith Hunter’s 500 hour yoga teacher training program, and one of 20 Athleta featured athletes in 2012. Please be in touch: sacredsourceyoga.com or facebook.com/SacredSourceYoga.

Editor: Seychelles Pitton

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