Asking Questions and Avoiding Unexpected Costs: Become an Empowered Patient
The World Health Organization has declared that the theme of this year’s World Health Day (April 7) is Building a Fairer, Healthier World. We know that the same as a person’s overall health, reproductive health depends on so much more than an annual visit to the doctor’s office. For example, where we are born, where we live, what we do for a living, and so many other factors influence the well-being of our bodies. To achieve reproductive well-being, people need high-quality, culturally competent information, access to health care, and the opportunity to use that information and take advantage of that access.
So it’s very important that everyone is on equal footing when making a health care appointment and throughout a visit with a provider. Not only can not knowing what to expect prior to seeing a provider cause unnecessary stress and anxiety, it can also lead to unwelcome surprise medical bills. And not feeling comfortable asking questions during a visit prevents patients from receiving the best care possible.
Start asking questions before setting foot in a provider’s office. When making an appointment, if you know what services you need, ask about the costs for those services from start to finish, including how many visits you will need and if any medications may be given. And it’s ok to ask what billing codes will be used. Knowing what may happen during a health care visit will allow you to preemptively check with your insurance to see what will and won’t be covered. Keep in mind that you may be the only one thinking about price before, during, or after a visit.
For example, if you want to begin using an IUD for birth control, some places may require two or more visits to a provider’s office; the first to speak to the provider about the IUD (and take an STI test) and a second to place it. But these two visits are not typically necessary, and IUDs can usually be placed on the day it’s requested, so ask if they stock the method you want and are able to place it that day to avoid making another appointment which could save money not only on visits but in other costs such as time off work, child care, and transportation.
Insurance companies are required to cover birth control, including IUDs, with no out-of-pocket costs but if you don’t have insurance (or you don’t have birth control coverage because your employer opted out) or don’t want to use your insurance because of concerns about privacy, it’s a good idea to call your provider first and make find out if your method and any related services, like anesthesia or testing for sexually transmitted infections, are covered. If paying for your birth control is a concern, some clinics offer services for free or at a reduced priced based on your income. If you are a student or covered under your parent’s insurance, see if they will consider only your income when calculating how much your method will cost. If you need to find a provider near you, check out Bedsider’s clinic finder. (If you are still paying out-of-pocket for your birth control, you can reach out to the National Women’s Law Center through their free CoverHer hotline for help.)
Depending on why you’re seeking care, a few questions to pose to your insurance company:
- Is the provider I want to see in-network?
- Is the facility I’ll be going to in-network?
- Have I met my deductible yet?
- What is my copay for this type of visit?
- What aspects of the care I’ll receive are covered?
- How much will I have to pay out-of-pocket for the care I’ll receive?
Don’t stop asking questions once you enter the exam room. Providers know a lot about medicine, but we are all the experts on our bodies. Speak up during a visit if you have questions about what you’re hearing or experiencing.
Depending on why you’re seeking care, a few questions to ask could include:
- Do I really need this test/procedure?
- What are the potential side effects?
- What are alternative treatments?
- Would it be safe to do nothing for now?
- Is there a generic version of a prescription available? Are there any programs to help decrease costs? (Some providers offer sliding scale fees, which means that the cost is adjusted by income.)
Press your provider if you feel they’re not taking your concerns seriously, and if they can’t answer your question themselves ask them to help you find a resource that can. If at the end of your visit you don’t feel that you got the best care possible from your provider, find someone new. Everyone deserves to experience health care that is thoughtful as well as thorough. No aspect of a person’s body or identity should impact the quality of the health care they receive.
If you receive an unexpected or incorrect bill after your visit call your provider for an explanation. And if your insurance company refuses to pay a claim you have the right to appeal.
In addition to advocating for yourself, it’s equally important to ensure that young people have the skills they need to receive quality health care. If you have a young person in your life educate them early, before it’s time for them to strike out on their own, to set them up for success. And starting conversations early about these types of issues and talking about them often allows the young people in your life to know that they can come to you with questions.
Teach them the basics: explain what health insurance is and why it’s so important.
Walk them through how to access care: explain the difference between primary, urgent, and emergency care. If your young person is going to college soon also make sure to talk about campus health centers.
Educate them on their health histories: make sure your young person knows what vaccines they’ve had, what prescriptions or over-the-counter medications they need, any allergies, and what surgeries they’ve had.
Practice asking questions: help young people practice by brainstorming questions that may come up during a visit and by sharing your experiences.
Once you’ve talked to your young person allow them to practice these skills by including them in decisions around their health care going forward. Letting teens take a more active role in managing their own care, while still letting them know that you’ve got their back, will give them the confidence to advocate for themselves and become an empowered patient early in life.