Psychotherapy Perspectives

Thursday, September 14, 2006

YOU are in charge of your Health-Advocating for Your Wellness

Sometimes we forget that we (the consumer of health care services) are in charge of our wellness. This is indicative of the system because often when we receive medical service whether it is psychiatric or for physical ailments it appears that the "experts" have all the power. That is not true, they are our consultants and we need to navigate our own health care by advocating for our wellness. This is true (we are in charge) whether we are in psychotherapy, counseling, or at our physicians office for a check up. The health care regulations make the consumer in charge of our own health. All of us need to take responsibility for advocating for our wellness by doing the following:


1. Recognize that you are in charge of your health.

2. Act in charge of your wellness

3. You are in charge of your health care plan and the health care rules protect you
a. The rules in health care are made to protect the consumer
b. The problem is that health care providers don't always follow the rules and forget that you run your own health care plan
c. Consumers win most appeals with insurance if you challenge them with their own rules

4. Take charge of your health care plan when in a hospital
a. Stay in the hospital for as long as necessary and until you have a safe discharge plan!
b. Make sure that representatives of all the physicians and hospital have a meeting called a care plan , so you understand what your choices are
c. Don't leave the hospital until your care plan meeting takes place and all your questions are answered
d. Make sure that you have a safe discharge plan to home or wherever you are going.

5. Take charge of your health care plan when you are with your physician
a. Formulate your questions before you see your Doctor.
1. Ask your Doctor what the numbers say or the % of this outcome.
a. Don't ask if you are going to get better, ask what the %‘s
2. Don't ask your Physician to play God; he/she is your consultant!
3. Don't ask your Physician about wellness, he/she doesn’t know—

6. When you are really sick, don't be a hero, get an advocate
a. Figure out who that should be before you get real sick
b. If you are having surgery, make sure you have a responsible person on site to sign for you at the surgical center and make decisions if you remain unconscious and something goes wrong.
c. Stop procrastinating and start paying into Long term care insurance before you really get sick and it is too late. It is one of the few insurance programs you will use when you are alive.

7. Most illness is life style related; change your life style to enhance wellness

8. Pay attention to what your parents are going through now and make an effort not to repeat it their mistakes when you get to be a senior.
a. Medicaid planning is for everybody whose estate is worth less then 2 million
b. Be wary of your parents "gifting" when they are sick, see your Medicaid planning attorney even if your parents never plan to be on Medicaid. It makes sense.
c. If your parents want a qualitative life style, make sure that they put enough money into "custodial care" or have a generous long term care insurance program for life.

9. Working with health care insurance
a. Study the small print of the booklet well
b. When you call your health care insurance representative make sure you do the following:
1. Get their name and number to respond to later
2. Most of the representatives do not give accurate information, make sure that they log what you ask into the computer and then log how they answer the question. If they won't log on the computer and print it out for you, then talk to their supervisor
3. Ask for their supervisor (ask nicely)
4. Ask for how to appeal their interpretation (you will probably win if you are persistent!
5. Ask them to fax or call when they logged the response on the computer.



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