Section 24.2 Participating in Your Healthcare Objectives Describe how to choose and participate fully in your healthcare. Compare different options for paying for healthcare.

Dear Advice Line, I just moved with my family to a new city, and I don’t have a doctor here yet. How can I make sure that the doctor we choose is the right one for me? Write a draft of a response to this question. Revise your answer after reading this section.

Your Healthcare Choosing Healthcare Deciding what doctor to see for routine healthcare deserves careful consideration. After all, you want your healthcare delivered by qualified people with whom you feel comfortable. Some people prefer to see a doctor in a clinic. Some people prefer to see a doctor who is in private practice.

Your Healthcare Finding a Doctor Ask for recommendations. The best way to begin your search for a doctor is to ask for recommendations from family members and friends. Do your research. When you have the names of some recommended doctors, you might go to your local library and check the American Medical Directory. Identify your preferences. Once you have the basic information, begin to think about your own preferences.

Your Healthcare Use this checklist to evaluate your current doctor.

The Doctor Appointment Your Healthcare The Doctor Appointment A doctor will usually first take your medical history, a record of your present and past health as well as the health of members of your family. You will have a physical examination, a head-to-toe check of your body to identify any medical problems you may have. If the doctor finds a medical condition requiring attention, he or she will discuss it with you. Your medical examination should also include time for you to ask questions. Regardless of how foolish you think your questions are, keep asking them.

Your Healthcare The Doctor Appointment

Your Rights and Responsibilities Your Healthcare Your Rights and Responsibilities In 1998, the United States Advisory Commission on Consumer Protection and Quality in the Health Care Industry adopted the Patients’ Bill of Rights. As a patient you also have certain responsibilities. You must fulfill these responsibilities in order to receive the best healthcare possible. Ask your doctor about anything that concerns your health. Answer your doctor’s questions honestly.

For: Updates on the Patients’ Bill of Rights Click above to go online.

Paying for Healthcare One way to pay for healthcare is to pay for all of your own medical expenses out-of-pocket. Health insurance pays for a major part of an individual’s medical expenses. Some companies offer health insurance options to their employees and their families. Individuals can also purchase their own health insurance.

Managed Care Insurance Plan members pay a monthly or yearly fee called a premium. Whenever they visit the doctor, they may also be required to pay a small fee called a copayment. Health Maintenance Organizations Members of an HMO choose a primary care physician who provides routine care and makes referrals to specialists within the network when necessary. Point of Service Plans Point of service (POS) plans require you to choose a primary care physician. Your primary care physician may refer you to specialists outside the network. Preferred Provider Organizations A preferred provider organization (PPO) also has a network of doctors who charge reduced fees to plan members.

Average healthcare spending for an American family of four

Traditional Insurance Premium Members of a traditional plan pay a monthly premium. Deductible Members are required to pay the first part of their medical expenses each year. This fixed amount, called the deductible, must be paid before the insurance company begins paying for covered procedures. Percentage Covered After the patient has paid the deductible, traditional plans generally pay only a certain percentage of the rest of the year’s medical expenses. Services Not Covered Some medical procedures and services are not covered by traditional plans.

Government-Sponsored Insurance Some people in the United States cannot afford private health insurance and are eligible for government health insurance programs. Medicare is the name for the federally financed insurance program for people over age 65 and for younger people who are disabled or who have chronic kidney disease. Medicaid is a state program that pays for the healthcare of people whose incomes are below a certain level.

Rising Healthcare Costs An Aging Population The growing population of elderly Americans is a major force in driving up costs. Chronic Diseases The increasing incidence of chronic diseases affects all Americans. When individuals require more and more medical care, health insurance companies must raise everybody’s premiums to offset the extra costs. Prescription Drug Costs The research and development of prescription drugs is very expensive, and this cost is usually passed on to consumers.

Vocabulary medical history A record of your present and past health as well as the health of members of your family. physical examination A head-to-toe check of your body to identify any medical problems. premium A monthly or yearly fee paid for health insurance coverage. copayment A small fee that a patient with managed care health insurance may have to pay when visiting a doctor. deductible A fixed amount that must be paid by the patient before traditional health insurance begins paying for covered procedures.

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End of Section 24.2 Click on this slide to end this presentation.