Now that open enrollment has arrived, I think now is a good time to talk about one very hot topic. That’s right, insurance. As a doctor, a mother, an employer, and a patient when it comes to medical coverage I am feeling the same heat that all of you are. And, there is no other way to say it … it sucks.
When it comes to my own personal care, I took control a long time ago. But then again, I’m a doctor! I have the knowledge, the training, and the judgement to manage my health. The real challenge for me is when I look around to see my patients, my children, and my employees struggling to get coverage for things that I deem as necessary medical expenses. Here’s just a glimpse into what I am currently seeing in my world …
As a doctor …
As a doctor working with the insurance companies is part of the job. While my end goal is always to keep my patients healthy and happy, sometimes coverage stands in the way of how physicians can provide care. The worst part of that is the tension that it creates between the doctor and the patient. My ask of all of you is to remember that we are on your side, and we’re doing the best that we can!
As a mother …
As any mother knows, when you have kids, insurance is a must! Yet, it doesn’t always work out. When my daughter Taylor was young she had trouble saying some words properly and so they recommended we take her to speech therapy. It was covered under our insurance and had been pre-certified so we went full steam ahead. I mean, why wouldn’t we? Well … after Taylor had been going to her regular sessions for months, the insurance company came back to us with some unfortunate news. Her therapy wasn’t covered after all, and that $2,500 bill? That was on us.
As an employer …
As a small, growing practice we don’t have a group plan in place so our employees have relied on individual plans for coverage. That always worked for us, until recently. Along with increasing prices and deductibles, some insurance carriers have decided to drop individual plans all together. Witnessing my own employees scramble to get coverage has opened my eyes to how widespread the issue has become. There is no easy way around it for employees and employers alike.
So, now you’re sitting there thinking that same thing that you’ve been wondering for months, maybe even years … what do I do about it? While I wish I could tell you that it will all get better soon, in reality I think it’s going to take a while. The truth is that the insurance companies can’t keep up with the costs of care so they are covering less and less. As we march forward into 2018 we have two options – carry on bearing the weight of our stress and frustrations – or – take control of our own care and make the best of it.
For the time being, I suggest we all choose option two.
To get started study your coverage so that you know exactly what you are working with. Understand your co-pays, which doctors are in network, and which hospitals you can go to. Try to navigate within those lines as much as possible in order to save yourself some money. And outside of what the insurance companies will pay for … well, consider this your opportunity to take charge.
One thing that has always been flawed about the insurance system is that it’s only designed to pay for things when people are injured or sick. Imagine how much better off our population would be if we had more affordable access to supplements, wellness visits, counseling, hormones, and gym memberships! Like I always say “an ounce of prevention is worth a pound of cure.” The secret is to be proactive instead of reactive.
The good news is that you don’t have to wait on the insurance companies to make positive changes in your own life. Through practices like Amy Brenner, MD& Associates, there are plenty of people who are on your side. From wellness programs to advanced screenings there is so much that you can do today! Why wait around until you get sick?!
I know the current situation is rough for everyone, but I’m here to remind you that you still hold the power to live a healthy lifestyle and reduce your dependency on the insurance companies. If you need help filtering through the noise and defining a plan, our team at Amy Brenner, MD & Associates is here to help. Deep breaths, you’ve got this!