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Your Healthcare Questions Answered

Lori-AnnThis is your chance. You know you have questions about your healthcare, whether it’s how to find the right physician for you, knowing the right questions to ask your doctor, why insurance is so confusing, and so on. Maybe you’re curious about how to handle your caring for your aging parents or deciding when to move them into assisted living. Whatever your question, now is your chance to ask the expert.

I have more than 30 years of experience working with healthcare professionals. I also got my (now grown) daughter through an illness at infancy and helped my dad with his healthcare and assisted living needs. I know how to get through these things as easily as possible and with minimal cost. So go ahead. Ask me anything.

Join me on Wednesday, January 27, 2016 at 2:00 p.m. Eastern for my latest webinar: Ask Lori-Ann Your Healthcare Questions. Register now.

You can bring your questions to the webinar or submit them in advance by email or on Facebook or Twitter.

Can’t wait to connect with you on Wednesday!

 

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How can I learn about doctor and hospital quality of care?

Caucasian woman holding baby and typing on laptop computer in kI get questions all the time about which doctor to visit or which local hospital is the best for certain services. There are many resources available to evaluate care.

First, start by asking your friends, family, and co-workers for recommendations. Hearing the experiences of people you trust offers helpful insights as you research your options.

There are also many websites dedicated to rating doctors and hospitals. Here are two that I like:

Healthgrades (www.healthgrades.com) is a website that allows you to search doctors, dentists and hospitals in your location. Patient satisfaction reviews are available to read comments and you can search doctors by specialty.

The Leapfrog Group (www.leapfroggroup.org) performs hospital surveys and provides comparable results on their website. They assess hospitals on how patients fare, resources used to care for patients, and leadership and structures that promote patient safety.

These are great places to start, but remember to continue your own research. Look at doctor’s credentials. See where they went to medical school, where they did their residency, and where they practice.

I always recommend calling the doctor’s office before committing. Make sure the doctor is covered by your health plan and accepting new patients. (Remember to ask the right question.) Also make sure the receptionist is courteous and professional. A rude greeting could be a sign that the practice is disrespectful of patients in general.

Most importantly, make sure you’re comfortable when you visit with the doctor. It is important that you can be open with your doctor and that you trust your doctor’s advice.

All this month we are answering your questions and we will be answering even more in this month’s webinar Ask Lori-Ann Your Healthcare Questions on January 27, 2016 at 2 p.m. Eastern. Reserve your spot now! Bring your questions to the webinar or submit them in advance by email or on Facebook or Twitter.

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What is the difference between HMO, PPO, POS, and EPS?

Young girl listening to young boy's heartbeat with stethoscopeMany of our readers have come to us with questions about the different types of health plans sold on the individual market.

Understandably, there is a lot of confusion about the types of plans because there are no industry-wide definitions and because state standards are different.

To help you better understand the different types of plans, here are some generalities:

Health Maintenance Organizations (HMO): HMOs only cover care provided by doctors and hospitals within the network.

Preferred Provider Organizations (PPO): PPOs cover care in and out of the plan provider’s network. There is typically a higher percentage of the cost for care provided out-of-network, paid for by the members.

Exclusive Provider Organizations (EPO): EPOs generally do not cover care outside of the plan provider’s network. They are similar to HMOs, but members may not need a referral to see a specialist.

Point of Service (POS): POS plans often combine aspects of HMOs and PPOs. There may be coverage for out-of-network care that comes with higher cost sharing. Members also may need a referral to see a specialist.

There is a lot of variety from one plan to the next, despite how the plans are labeled.

When looking at plans, make sure to ask some basic questions about coverage, such as:

  • If members are required to have a primary care physician,
  • If members are required to get referrals for specialists or services,
  • If any healthcare services need to be pre-authorized,
  • If there is out-of-network coverage, and
  • If there is out-of-network coverage, does spending count toward the out-of-pocket maximum?

All this month we are answering your questions and we will be answering even more in this month’s webinar Ask Lori-Ann Your Healthcare Questions on January 27, 2016 at 2 p.m. Eastern. Reserve your spot now! Bring your questions to the webinar or submit them in advance by email or on Facebook or Twitter.