#6 Ways to Navigate the Healthcare System

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Our healthcare system is complicated to understand, even if you’re perfectly healthy. However, the healthcare system can be even more horrifying if you’re living with a chronic illness like Essential Tremor. Finding a good doctor, affording medication, and reducing your overall healthcare costs can feel impossible if you’re unprepared.

Besides managing your disease at home based on your doctor’s guidance, you must work with specialists, deal with expensive medical bills, and coordinate your own care—all of which can be confusing, time-consuming, and virtually impossible if you’re not educated on the system. In addition, managing the financial burdens of healthcare is overwhelming for many people. Here are a few tips to help you navigate the complex healthcare system:

1. Always Ask Questions

Medical errors are common and can cause death, so patients should prepare before medical procedures to reduce their risk by asking questions and doing research. You should know what the procedure involves, why it’s being done, and what the recovery will look like. For example, if you are taking care of a loved one with an illness, your doctor should let you know how to protect yourself with a mask or by washing your hands in the sink often. Or if you are experiencing erectile dysfunction, you should feel comfortable talking to your doctor about the different options out there for you like Cialis. You should remember to work with your doctor, and you can ask as many questions as you want or refuse treatment if you believe it’s in your best interest or want to get a second opinion.

2. Have an Advocate

Understanding the complex healthcare system on your own is challenging. Still, you can reduce your risk and ensure you have all the necessary information by having an advocate, such as a family member, who can discuss everything they need to know with overworked nurses. Since many healthcare facilities are understaffed, nurses and medical assistants may not have the time to offer a high level of hands-on care. Therefore, it’s essential to ask questions and have someone who can advocate for you by questioning everything until you understand your health needs.

Unfortunately, errors happen in healthcare. For example, medication errors can occur when patients don’t get the correct information or misunderstand certain information about their medications or dosages. Therefore, before taking medication, you should understand exactly what it is, what it’s for, and how it should be taken.

Your advocate should be friendly and polite to help you get better care and try to learn about everything from medications and other treatments to the type of care you’ll require so they can easily explain it to you.

3. Know Your Rights

Every patient has rights they’re entitled to ensure they get the best possible care. A few rights you’re entitled to as a patient include the following:

Second opinions: If you’re unsure whether a doctor has made a correct diagnosis or treatment plan, you can refuse treatment and get a second opinion to be safe. You can get a second opinion in the same office or a different one, and your physician has no right to get angry with you. You should feel free to see any provider you trust, so if for some reason you don’t trust your current doctor or their expertise, you can always find a new one.
Personal medical records: Patients are entitled to a copy of their medical records, office visit notes, tests, and lab results. This federal law allows patients to access any medical information they need to make the right decision for themselves and may be available as an e-chart or printout, depending on the provider.
Fee explanations: Healthcare costs continue to increase, and many people are starting to question fees on their bills. If you have insurance, you can reduce at least some of your health expenses, but most people will need to pay out of pocket for care. You can and should always ask for an explanation of your medical billing statement and the providers listed on the statement to ensure you’re not being overcharged.

4. Understand Payments

As we’ve stated, healthcare costs continue to rise year after year, so it’s essential to understand your bills and the costs of care. You can pay for care in several ways, including payment plans with hospitals, payments to providers, and patient assistance programs. Hospital care is expensive, and most people won’t be able to afford their bills in a single payment. Therefore, hospitals offer assistance plans when you need them, which you can usually apply for by contacting their billing department.

You can also set up payment plans with doctors’ offices if you can’t pay for the services upfront. Additionally, pharmaceutical companies may offer assistance programs, so always ask your healthcare provider for more details.

5. Compare Pharmacy Costs

Medication costs have increased exponentially in the last decade, and many health insurance plans no longer cover many brands or prescription types. Drug prices vary by pharmacy because insurance companies aren’t regulated, and pharmacies set the prices you pay using rebates and coupons. To find the best prices, you can compare pharmacy costs to ensure you’re paying as little as possible.

6. Choose the Right Insurance Plan

Many people want to save as much as possible on their insurance plan because it’s a fixed monthly cost they can predict. However, paying for a cheap plan can cost you more in the long run, especially if you suffer from a chronic illness. Even healthy people who choose low-cost insurance plans may find themselves paying out of pocket for treatment they couldn’t predict, so it’s crucial to find an insurance plan that fits within your budget and can cover most of your medical costs.

If you’re over 65, you qualify for Medicare, a program in which the government pays for most of your healthcare costs. Meanwhile, if you’re younger than 65, you might get insurance through an employer which covers a large portion of your premiums. Of course, some individuals may have to choose their plan directly through the marketplace if they’re self-employed or business owners, so there’s no guarantee that they’ll be able to save on their premiums.

Most people choose their health insurance plan based on what they already know about their health. For example, young, healthy individuals may choose a catastrophic or basic plan because they don’t visit their doctors very often. However, the downside is that if something happens, such as being diagnosed with a serious disease or a car accident, insurance is unlikely to pay the bulk of the hospital fees.

Navigating the Healthcare System

No one enjoys navigating the complex healthcare system. However, you can talk to other patients to help you find doctors and discuss treatment options to help you make better decisions for your health. You can meet people at your doctor’s office or online to learn about their experiences and get the necessary advice to make the right decision for yourself. Remember, only you can choose your doctor, care, and treatment. A doctor can provide advice based on their expertise, but the final decisions are up to you.

Ashley Nielsen

Ashley Nielsen earned a B.S. degree in Business Administration Marketing at Point Loma Nazarene University. She is a freelance writer who loves to share knowledge about general business, marketing, lifestyle, wellness, and financial tips. During her free time, she enjoys being outside, staying active, reading a book, or diving deep into her favorite music.

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