Health Insurance and Payments (USA focused only)

Post 1: I haven’t been to a doctor in a while can be found here
Post 2: Checkup can be found here
Post 3: I’m Sick: To go or not to go can be found here
Post 4: Diagnosed but not happy can be found here

Many people need a doctor but cannot afford it. There are some options out there [besides trying to find your answers on this blog. Shocking isn’t it???]

This post contains a few resources (for US residence only) to help. Dr. Carm does not represent any of the following, and unfortunately, they probably would deny Dr. Carm’s existence. Try not to judge them by this foolishness.

Here are a few resources to look into to:

· http://finder.healthcare.gov/
Healthcare.Gov "This tool will help you find the health insurance best suited to your needs, whether it's private insurance for individuals, families, and small businesses, or public programs that may work for you. It was created to help consumers under the health insurance reform law, the Affordable Care Act."

· http://medicaid.gov
Medicaid Each state operates a Medicaid program that provides health coverage for lower-income people, families and children, the elderly, and people with disabilities.
The eligibility rules for Medicaid are different for each state, but most states offer coverage for adults with children at some income level. In addition, beginning in 2014, most adults under age 65 with individual incomes up to about $15,000 per year will qualify for Medicaid in every state.

· http://InsureKidsNow.gov
Children’s Health Insurance Program (CHIP) "CHIP covers children whose families don’t qualify for Medicaid but can’t afford to buy health insurance. CHIP provides low-cost health insurance coverage for children in families who earn too much income to qualify for Medicaid coverage but can’t afford to purchase private health insurance. CHIP is a state and federal partnership program that works closely with Medicaid. Every state operates a CHIP, although most states have unique names for their programs like Child Health Plus (New York), Healthy Families (California), and Hoosier Healthwise (Indiana). In several states, CHIP and Medicaid are combined into one program.”

· Community Health Centers “A network of community health centers across the country provides preventive and primary care to millions of Americans. They provide care for free or on a sliding scale based on your income”

· Self-Employed "If you are self-employed with no employees, you now have several options for insurance coverage. In 2014, those options will expand under the Affordable Care Act….”

o If your state allows self-employed people to buy small employer health insurance, then you have similar options as small employers. Find out if you qualify by visiting your State Department of Insurance. Or find additional consumer assistance in your state.

o If your state doesn’t allow self-employed people to buy small employer health insurance, then you have the same options as someone buying an individual health insurance plan.

· Contact DHHS directly:
The U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Telephone: 202-619-0257
Toll-free: 1-877-696-6775

· Health Resources and Services Administration [mchb.hrsa.gov]
The Health Resources and Services Administration (HRSA) of the DHHS website, Maternal and Child Health Bureau (MCHB), whose goal is to ensure equal access to quality health care in a supportive, culturally competent family and community setting.

· Contact MCHB Directly:
Maternal and Child Health Bureau (MCHB)
Parklawn Building
Room 18-05
5600 Fishers Lane
Rockville, MD 20857
Phone: 301-443-2170
Fax: 301-443-1797
E-mail: ctibbs@hrsa.gov

· Family Voices offers resources and communication opportunities on the Internet for people with cognitive and other disabilities, for their families, and for those who provide services and support. This resource has a special interest in the care of children. Resources state by state.
Family Voices[familyvoices.org]
2340 Alamo SE, Suite 102
Albuquerque, NM 87106
Toll-free: 888-835-5669
Phone: 505-872-4774
Fax: 505-872-4780
Online E-mail Contact Form: http://www.familyvoices.org/contact

· Health Care Choices provides information to the public on selecting and using various types of health insurance and managed care plans.
Health Care Choices
P.O. Box 21039
Columbus Circle Station
New York, NY 10023
Toll-free: 800-368-5779

Related Postings:
Preparing for Your Appointment 
Checkups 
I'm Sick (when to go to the doctor's) 
Diagnosed But Not Happy 
Best Medical Schools

Diagnosed but Not Happy

Post 1: I haven’t been to a doctor in a while can be found here

Post 2: Checkup can be found here
Post 3: I’m Sick: To Go or Not to Go can be found here

Diagnosed but Not Happy

So you are not happy with the results of your doctor's appointment. Apparently, you didn’t see Dr. Carm. That’s okay. We all make mistakes. But anyway, if you think there is something your doctor is missing, talk to him or her. Ask questions and be clear on why they did or did not diagnose you with something. [Not all doctors can be as smart as Dr. Carm. Let’s try not to hold that against them.] Don’t be afraid to express your opinions (politely.)

Try to work with the doctor’s solution(s). Maybe you are missing something. If this doesn’t work or you are still unsatisfied, then look around for another opinion. For example, find someone who has more experience in that particular field.

Also, if you are unhappy with the medication or procedures to your disease or illness, ask for alternatives. For instance, some doctors have more experience with natural remedies than others. Each doctor is familiar with certain medications and treatments, and they tend to stick with them. Most of the time there are other options out there. Understand these options and the consequences with your treatment. If you do not feel right with the given treatment and have discussed this with your doctor to no avail, try finding another physician who may provide you with better options and opinions. [Note: always take medication as prescribed. Do not stop taking medication unless directed by the doctor.]

The important thing is to be honest and open with your doctor. Make sure you understand things. Some doctors may not be aware that you do know or understand a medical term. Just ask! This could help you in the long run and become more satisfied with your appointment.

As always, if you have any questions for Dr. Carm, don’t hesitate to ask. She is the best uncertified doctor out there!

Related Postings:
Preparing for Your Appointment 
Checkups 
I'm Sick (when to go to the doctor's) 
Health Insurance
The Hospital
Can You Read This?

I'm Sick: To go or Not to Go

Post 1: I haven’t been to a doctor in a while can be found here
Post 2: Checkup can be found here

I’m Sick: To Go or Not to Go

Not feeling well? That’s too bad! Could you just take a few steps back? A little more…there! Good! Dr. Carm doesn’t want to get sick. Okay, so you are wondering when you should see a doctor. You’re sick but obviously not dying (yes, I know—it feels like it.) Here’s a simple way for doctors to know if they should see you (besides the symptoms of course):

If they need your money = tell the patient to come in.

If they are too busy = tell them stay home.

Nice and easy, right?

So, let’s talk about you as a patient. First rule, whenever you care in complete doubt as to whether to see the doctor or not, call the doctor’s office.

If you are medically inclined (like Dr. Carm), you can do some research on your symptoms. Unfortunately, most websites will probably tell you that you are dying (which isn’t exactly false) or that you have cancer or some weird disease you can’t pronounce. In this case, Dr. Carm has made a list for you. Here are some signs where you should call your doctor (in no particular order):

·         Repeated episodes (dizziness, sleep problems, fatigue, headaches, weight gain or loss, pain, nauseas, vomiting, diarrhea, constipation, abdominal pain, depression or anxiety, panic attacks, pelvic pain)

·          Possibility of a STD (sexual transmitted disease)

·          Numbness

·          Persistent swelling, nosebleeds, jaw pain

·          Blood in stool or urine

·          Severe and persistent sore throat or coughing

·          Hearing loss

·          Severe injuries (cuts/wounds/animal bites that break skin/puncture wounds)

·          Thoughts of suicide

·          Hearing voices

·          Blurry or double vision

·          Eye pain or excessive eye discharge

·          Sensitivity to light

·          Shortness of breath/wheezing

·          Rashes or welts that do not clear up

·          Serious burns or blisters

·          Mole changes

·          Sore that won’t heal

·          Unusual lumps

·          Bleeding during pregnancy

·          Menstrual changes (prolonged, heavy, missed periods, vaginal discharge)

·          Pain during intercourse

[Remember: If you are Dr. Carm’s patient—don’t contact her, she’ll contact you]

As always, if you have any questions for Dr. Carm, don’t hesitate to ask. She is the best uncertified doctor out there!

Related Postings:  
Preparing for Your Appointment
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Diagnosed But Not Happy
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Sneeze Record
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Checkups

Post 1: I haven’t been to a doctor in a while can be found here

Checkups

Checkups are important for you and your doctor. During checkups, you take a step towards preventing any diseases or illnesses. You become a master of your own health. If the doctor is like Dr. Carm, then she likes checkups, too. She can get updated information on her patient (and interesting gossip). Doctors care about you—and I’m sure everyone cares about Dr. Carm!

What to expect at you annual exams

Don’t worry you usually don’t have to study, and you don’t usually have to worry about filling in those annoying tiny bubbles on the test sheet. [Dr. Carm hates exams.] Annual exams can include: checking vital signs (blood pressure, heart rate, respiratory system, and temperature), testicular exam, hernia exam, penis exam, prostate exam, breast exam, pelvic exam, CBC (complete blood test), chemistry panel, and urinalysis.

Your age, sex, and medical history determines which exams you need. In addition to the ones mentioned above, you should also be aware:

-If you are 50 years and older (sorry, can’t lie about your age here), you should go for colorectal cancer screenings. A fecal occult blood test (FOBT) should be performed 1 to 2 years for people 50-80 years old. Other testing such as a colonoscopy can be done every 5-10 years depending on health risks. For those who have a family history of colon cancer or other colon-related diseases (such as crohn’s disease), tests are usually done prior to age 50. Catching colon cancer early is essential for successful treatments.

-Annual mammograms should be done for women starting at the age of 40. Dr. Carm knows one place that suggests women start their annual mammogram testing at age 35.

-Cholesterol testing (lipids) should be done every 5 years after the age of 20.

*Blood tests can vary between individuals depending on their medications and health.

What should you do to prepare for your checkup?

Besides making the appointment [doctors usually hate it if you just stop by for a chat and say, “Oh, while I’m here, could I have my checkup?”], you can make a list of items to discuss or questions to ask. You know your body and should be aware of any changes. Well, Dr. Carm hopes you do. We don’t have any aliens inhabiting any bodies out there, do we??? Never mind, I don’t want to know….

What should you list?

Did anyone in your family (blood related) get diagnosed with a disease (for example, your sister is diagnosed with lung cancer or your father is now on cholesterol medication)?

Has something been bothering you? A pain? A cold that keeps coming back? Changes in diet or sleeping patterns?

Have you started taking any medication or supplements recently? (More than likely this should be over the counter medication/supplements. Dr. Carm does not approve illegal drugs. People are usually crazy enough without them.)

If something is bothering you, write down why (why does it bother you?), what (what kind of concern is it? Can you describe it?), when (when did it start? How long does it last?), where (where does it hurt? Do you get the symptoms in certain places?), and how (how have you been dealing with it?).

Last points

Remember you can’t undo a year’s worth of damage in a week! [Yes, those pesky diets to lose weight that didn't work because you didn't actually follow the diet counts.] Doctors (that aren’t even Dr. Carm) are usually smart enough to notice this, although they might not outwardly mention it. So, speak truthfully to your doctor. They can’t help you if you hide information or lie to them.

If you need a follow up appointment, schedule it and keep it. There’s a reason why your doctor needs this information. Let him/her help you!

As always, if you have any questions for Dr. Carm, don’t hesitate to ask. She is the best uncertified doctor out there!

Related Postings:
Preparing for Your Appointment 
I'm Sick (when to go to the doctor's) 
Diagnosed But Not Happy 
Health Insurance 
Pelvic Exam 
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Eye Exam 

Preparing for Your Appointment

This posting is split up into the following:

Post 1: I haven’t been to a doctor in a while: What to expect and do

Post 2: Checkups

Post 3: I’m sick: To go or not to go

Post 4: Diagnosed but not happy

Post 5: Health insurance and payments help (US focus only)

I haven’t been to a doctor in a while: What to expect and do

First off, this is completely understandable. Dr. Carm hasn’t been practicing professionally until recently, so you had no choice but to see a “certified” physician. Doctors can seem scary; they might even be crazy! They hold the power of you ignorant bliss in the palm of the rubber-gloved hand. As a fake doctor, I must insist that it is important to go, even if you are healthy. When you go for a checkup, it gives the doctor a chance to discover any potential problems and fix them before they get out of hand.

“I don’t need a lecture, Dr. Carm. This is precisely why I hate going. I’m not scared of dying [or, I don’t care if I die]. I rather not know if something is wrong.” Yep, Dr. Carm heard you. She has those kinds of skills!

Believe it or not, Dr. Carm has felt that way, too. (This was obviously before she became doctor.) What you want to do is find a doctor that suits you. Dr. Carm is extremely busy and cannot see every person. Therefore, it is a good idea to shop around for a certified physician (preferably one under your insurance, if you have any.) If you visit a doctor that you do not feel comfortable with, you don’t have to go back. Look around some more until you find one that can understand your needs. Not everyone’s personalities get along. Therefore, don’t feel bad if you feel the need to change doctors.

The internet provides loads of information on different offices. If you know that you have some digestive problems, than look for an office that has a doctor that specializes in that area (gastroenterology). There are offices that cover multiple specialties, conduct their own blood tests, include physical therapy, allergy testing, pediatrics, radiology, sleep medicine, etc. Research the doctors available at that office. Consider this: Do you feel more comfortable seeing a male or female doctor? Look at their specialties. Will this benefit you? How far is the office? What are their hours? Ask your friends and relatives about their doctors? What do they like or dislike about them and how the office is run? If you cannot find something on their website or by asking friends, call the office and get your information. Don’t worry. They can’t bite over the phone, and you don’t have to make an appointment right then and there. [If they heard of and support Dr. Carm’s practice, then go with that office no matter what. These are really smart people!!!]

Okay, so let’s say you found a doctor that you feel will work with you and is almost as great as Dr. Carm. (We all know that she’s the best. Let’s not deny that part! But, other doctors can be good, too.) Now what?

Well, you’ll want to prepare for your appointment. Although you might think this means panic attacks, sleepless nights, and alcohol, there are some other things that you should be ready to provide.

First, most offices provide their paperwork online for you to fill out ahead of time. Take a look and take your time filling out those forms. This means:

·         Know your insurance information. Call your HR department if you have any questions over copays or coverage. It’s best to know what is covered now than getting stuck with a large bill later.

·         The forms will ask you about your health, family medical history, allergies, shots, etc.
By preparing for your appointment, you have a chance to ask family or close friends if you are unsure about any family’s medical history. Stay within the immediate family: Children, parents, grandparents, aunt, uncles, and cousins. If you are adopted, then provide whatever information you know. It might be limited, but it would be helpful to the physician. Major diseases or medical problems such as cancers, heart disease, diabetes, cholesterol, thyroid disease, mental illnesses, etc. should be disclosed. Things like “Uncle Buck lost his finger while teaching shop class” and “Great grandma got bitten by her hog three times in five years before she died” are not necessarily helpful information (although they are interesting conversation starters.) You can post those stories down below for Dr. Carm’s enjoyment.
Know your own medical history. For instance, are you up to date on vaccinations? No idea? Don’t panic. It’s okay if you don’t remember all the vaccinations. They won’t give you all the shots again because you aren’t sure. Think of any continuing illnesses or pains. Is there something that is bothering you but you’re not quite sure what it is? This is the time to mention it. You know your body better than anyone else. Take the time to think about it and ask if this is something that should be looked into. Most of the time there is no big concern. It can also be a sign of something else, perhaps a hormone imbalance. These little bits of extra information can help the doctor determine if anything is wrong, and if something needs to be done, what exactly should be done.
List your medications. Yes, this includes supplements! Supplements can cause interactions with other medications. You also want to let them know if you had any problems with prior medication such as penicillin. We don’t want you to turn into the Stay Puft Marshmallow Man from anaphylactic shock!

The forms will also ask for health habits. This would be things like smoking, wearing a seatbelt while driving, caffeine intake, drug use, and alcohol consumption. Be truthful! We all have bad habits (except Dr. Carm, of course.)

·         If you have questions, write them down ahead of time. There can be so much information passing between you and your doctor in the appointment that you might forget to ask. If you do, just call back later. If you are going to the doctors because of a concern, write down your symptoms. When did they start? What is their intensity? What makes you feel better [you might want to consider other alternatives to mention besides drinking until passing out]? What makes you feel worse? Do the symptoms go away? How long do they typically last? What are some other symptoms that you have that you don’t think are related? And, why do you think this?

After the appointment, make sure you do any necessary follow ups, such as blood test or other appointments. Try to make the appointment that same day or call back within 24-28 hours. In the meantime, a lot of places offer online access to health care. Take advantage of it. For example, you can view your blood results online. Some doctors have services online, where you can ask questions without stepping inside the office.

And, of course, if you have any questions for Dr. Carm, don’t hesitate to ask. She is the best uncertified doctor out there!

Picture: Stay Puft Marshmallow Man is from the Ghostbusters movie (1984)

Related Posting:
Checkups 
I'm Sick (when to go to the doctor's) 
Diagnosed But Not Happy
Health Insurance