Talking to Your Doctor
After Your Appointment: What Comes Next?
Making the Most of your Doctor's Instructions
A regular checkup with your doctor may lead to some new questions. Your doctor might need more information to diagnose a problem or treat your health. Or, you may need to see a specialist or get a test. These things may take a little more time and energy, but your health is worth it.
Before the appointment, make sure you are familiar with your health benefits plan. You can find information on your health insurance company’s website. You can also ask the HR representative in your office. Health insurance can be confusing. If you still have questions, don’t panic. Click here to order a free copy of Navigating Your Health Benefits for Dummies.
Tests, Screenings and Prescriptions
Your doctor might send you for a test, such as a cholesterol screening or a mammogram. Tests can help catch minor problems before they get worse. They can also spot serious problems that need to be treated. Or, your doctor may say you need a prescription drug. The right drug can cure or treat a condition you have or keep you from getting new ones.
If your doctor asks that you take a test or get new medicine, be sure to ask why. It is important that you have all of this information. It will keep you informed about your health.
Before you go for a test or pick up your medicine, make sure your health insurance "covers" these things. This means that your health benefits plan will pay for all or part of the test or drug. Here's how to find out:
- Ask your doctor
Sometimes, a doctor's staff will know what your health insurance covers. This is not always the case though. If not, ask for all the information about the test or drug. Write everything down. Or ask the staff to write it for you. - Check with your health benefits manager or health insurance company
Tell them about the test or drug your doctor recommends. Use the information your doctor gave you. Customer service might be able to tell you if it is covered by your plan. - Ask your pharmacist
Bring your prescription to your pharmacist. The pharmacist will tell you if your health insurance pays for the drug. Sometimes your insurance will not cover the cost of the drug. Or, it might only cover a small portion. Then, you will have to make a co-payment. This is the part you have to pay. If that is the case, ask the pharmacist if there is another option. If there is, he or she might be able to contact your doctor and change the prescription.
Visiting a Specialist
Your doctor may send you to see a specialist. This doctor focuses on one area of medicine. For instance, cardiologists treat heart trouble. Before making an appointment, find out if the specialist takes your insurance. Here's how:
- Look online
Check your health insurance company's website. You can look up the specialist and see if the specialist is in your health plan’s network. - Check with your health benefits manager or health insurance company
Ask if the specialist takes your insurance. If the answer is no, you may be able to get a list of doctors in your area who accept your insurance. Also ask if you need a referral. This is a process your doctor handles before you visit a specialist. If you need a referral and don’t get one, you may have to pay for the visit to the specialist. - Call the specialist's office
Tell them what insurance you have. They can tell you if the doctor accepts it.
What If I Am Not Covered?
If your insurance doesn’t cover a test or specialist, there are steps you can take to save money and still get the care you need:
- Do some research
If you need a specialist who takes your insurance, call your insurance company or visit their website. They will list doctors in your area who accept your insurance. If a test or drug your doctor suggests isn’t covered, tell your doctor. There might be other options that are just as helpful and that your insurance will pay for. - Use a Flexible Spending Account
Some health insurance plans offer Flexible Spending Accounts (FSAs). With FSAs, a set amount of money is taken from your paycheck before taxes. (You decide how much). You can use this money to pay for certain medical expenses not covered by your insurance. - Find out about reimbursement
Some expenses or specialists may not be covered by your plan. If you have to pay for the expense yourself, you may be able to submit a claim to your insurance company. The company could decide to pay you back (reimburse) some of the costs. Call the customer service department at your health insurance company to learn more.
Here's another good idea. Have a translator ready when you follow the steps above. Not everyone you need to talk to will speak Spanish.