September 27th, 2019 BY HealthNetwork
Doctors have a lot of knowledge to offer, but one of the things they lack is time – time spent talking to you and getting a better sense of your overall health. That means sometimes things get overlooked during routine exams. When you make a doctor’s appointment, you might have a few things to ask about, but time pressure might mean you only hit the highlights. This is especially true when you have government-subsidized insurance like Medicare coverage, which pays less than private insurance to your healthcare provider.
In an emergency, control over your care often leaves your hands entirely. You trust medical staff to make the right decisions and provide the care you need. Unfortunately, doctors, nurses and other healthcare providers are human. They make mistakes and overlook things. It’s up to you to make sure that you get great care, whether or not you’re on Medicare or a Medicare Advantage plan through a private insurance company.
Many seniors don’t like to challenge their doctors, even if they disagree with a diagnosis or have questions about their care. Maybe it’s generational, or maybe you’re just not someone who questions authority. But doctors, while authoritative and knowledgeable, don’t always get it right. Speak up for yourself – or enlist the help of a family member or friend who will do it for you – and be “pushy” when it comes to your healthcare.
Asking Questions isn’t Being Pushy
First and foremost, know that asking questions isn’t the same as being combative. The more you know about your health, the more proactive you can be about treatments. If your cholesterol is creeping up, visiting a nutritionist might be a good first step to getting it under control. Medicare Advantage plans may not cover a visit to a specialist without a referral. That means the first step could start with your doctor. If you don’t ask for a referral, your doctor may start a treatment plan that involves a prescription, not one that starts by addressing your diet and daily life choices. Doctors want their patients to be proactive, so don’t hesitate to bring up concerns and press for more information. You’re not being belligerent. You’re being a good patient.
Educate Yourself about Your Health
Your doctor might see hundreds of patients each day, all with different levels of knowledge about general health. To get the most out of your doctor/patient relationship, you need your provider to take your concerns seriously. When you know more about your health and maintenance, you can ask the right questions and engage in a productive conversation with doctors. When you get a diagnosis, do some research to make sure you understand the implications of your condition and potential treatment options. If you don’t ask about the newest treatments by name, you might not get them.
Keep in mind that your primary care doctor has a lot of general knowledge, but he isn’t a specialist. He may not know about new research that relates to a specific diagnosis. Even specialists can only focus on a small fraction of the research released each year. You don’t need to earn a medical degree if you’ve been diagnosed with an illness, but it never hurts to learn more about the treatments available, as well as the outcomes and lifestyle expectations, so you can talk to your doctor more specifically about your situation.
Understand Your Insurance
Sometimes, your doctor offers standard care options that are covered fully by Medicare while other treatments may require extra steps. That doesn’t mean your insurance won’t authorize alternative treatments, but you might need to ask and follow a protocol to get there. Even if a particular prescription drug isn’t typically covered, you can still ask for it. As long as you’re willing to try alternatives first, most insurance companies, even Medicare Advantage plans, will work with you if you have worrying side effects with the covered options.
Read your health plan carefully, and make sure you evaluate it each year during the open enrollment period for Medicare. It’s your chance to shop around for a different plan, one that might offer better coverage or lower premiums.
You have a lot of decisions to make about your health coverage. These decisions can affect which doctors you can use, determine which hospitals are in your network, and even which medications you can use under your plan. Part of being a good health advocate for yourself is knowing what kind of coverage you need so you don’t have to worry about excessive medical bills.
Be Your Own Advocate
Many insurance companies offer assistance by phone for health questions, so you’re not limited to the doctor’s office if you’ve got concerns about your treatments. If you want to explore your options, making a phone call is not being pushy. If you’re concerned about possible side effects from a particular drug, asking is not being pushy. If you want to get a scan or have something looked at in more detail, that’s not being pushy, either.
Advocating for your health is not being pushy. It’s being smart. Medical errors account for over 440,000 deaths at hospitals each year according to some estimates. If asking a question or making a healthcare professional take you seriously feels pushy, just remember that it may save your life.
When and How to Asks the Tough Questions
Don’t wait until after Medicare enrollment to start asking questions. If you already take regular medication, you’ll want to make sure it’s covered by whichever plan you choose. If you have a doctor you like, you don’t want to be forced to switch. Avoid these issues by starting your advocacy at the starting point for healthcare: choosing your insurance. Once you have your insurance nailed down, continue to ask questions and follow up about health concerns until you get answers. It can take time to get a final diagnosis or move past initial testing, but be persistent and keep it up. Being your own advocate might feel intimidating, but it’s also empowering, so don’t be afraid to be pushy.