Are You a Consumer when it comes to Healthcare???

15 Feb Are You a Consumer when it comes to Healthcare???

Taking care of oneself or taking care of others can be overwhelming and intimidating. Especially when it comes to going to the Doctor, potential blood test and the outrageous cost that comes along with it. For instance, when you visit your Doctor for a physical (preventive care) which is covered under the 10 essential benefits https://www.healthcare.gov/blog/10-health-care-benefits-covered-in-the-health-insurance-marketplace/   , what about the blood tests that’s recommended by your Doctor, are they covered? If not covered what’s the cost? This is where the consumer part comes in. For instance, at your preventive care appointment you were told by your Doctor that your cholesterol is high, your bordering hypertension and you need to lose some weight. You make a conscious effort to exercise, watch what you eat and drink & control your stressors first to prevent from going on medication. Now most insurance plans cover cholesterol screening (lipid panel) once every 2-5yrs meaning it’s only covered under your insurance if you’re within their allowed time frame or the Doctor states that it’s medically necessary for you to have this test. Even then you may have a push back from your insurance company, meaning they won’t pay. As a consumer for your health, according to the Patient Bill of Rights and consumer rights (https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Market-Reforms/Patients-Bill-of-Rights.html , you as a consumer have the right to be informed and that means knowing all cost for the services you are seeking. Definitely, situations come up that are unexpected and need to be addressed but for the most part your medical bill shouldn’t be a big surprise. For example, you’ve been taking care of yourself and you want to see if you’ve made any progress in lowering your cholesterol, but because it’s potentially not covered by your insurance company what’s the cost and do you need to see your Doctor to get permission for this test?  In the state of Arizona, Governor Doug Ducey http://azgovernor.gov/ , passed a law( http://azgovernor.gov/governor/news/governor-doug-ducey-signs-legislation-reducing-barriers-efficient-cost-effective ) this year, which states you know longer need a Doctors order to run lab test. This is great news for consumers. Keep in mind typically this is an out of pocket expense but the upside you can shop around to find the best value for your test. Also the patient may not be a Doctor therefore, you may need results deciphered by one. All and all this is a step in the right direction giving the patient the reins of their life to check if progress is being made or alarming them that the problem needs to be addressed by their Doctor.  Empowering patients on their health and potentially containing their costs is absolutely a win win. Check with your state representative to see if this law resides in your state. Remember you’re the consumer!