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About The independent. (Vernonia, Or.) 1986-current | View Entire Issue (May 17, 2007)
Page 8 The INDEPENDENT, May 17, 2007 To Your Health! By Judy Hargis, P.A., and Audeen Wagner Navigating the Complex World of Healthcare “Unless you are Bill Gates, you are just one serious illness away from bankruptcy” — Dr. David Himmelstein, Associate Professor, Harvard Medical School. One of the most daunting issues facing Amer- icans today is how to pay for their healthcare. Over 40 million Americans have no form of health insurance and many others have no choice in the plan they have. For those who do have a choice, the process can be overwhelming. Some employers offer more then one choice. There are many options if you are seeking private health in- surance. For those who are eligible for medicare, there are different options for medigap coverage. Then there is Medicaid which can have several plans available, depending on the state. Many people are not even aware of their options or that they might be eligible. It can be very challenging to know where to get started and how to navigate through all the options and information if you are one of the unin- sured or underinsured. It is easy to see why individuals become discouraged and give up before starting or completing the process. Let’s talk briefly about the differences in health insurance coverage. Insurance plans are either indemnity plans (“fee for service”) or managed care plans. There are important differences in these plans in several areas. These include choice of providers, out-of-pocket costs for covered services (what you will actually pay) and how bills are paid. Indemnity plans generally offer more choices in doctors (includ- ing specialists such as cardiologists), hospitals and other healthcare providers. Managed care plans have agreements with specific doctors, hospitals and health care providers who provide a range of services. Basically, you will have lower out- of-pocket costs if you select a managed care type plan and a broader choice of healthcare providers with an indemnity plan. There are three types of managed care plans. These include: PPOs, HMOs and POS plans. The differences in these plans are clearly outlined in “Choosing and using a health plan” which is available at the website * below. It is important that you understand the differences in plans you are eligible for and the overall costs to you. You must also factor in the needs of you and your fam- ily and the impact of these costs on your budget. Whether you are receiving health insurance through your place of employment or buying private insurance, it is im- portant to understand the “true” costs and extent of the coverage you will be receiv- ing. You can do this through your benefits office at work or by accessing some ex- cellent websites online. Over the years, we have seen the impact of unexpected medical bills on patients who thought they had “good insurance coverage” and had- n’t factored in the high deductibles or mounting costs of copays for office, hospital or ancillary health care services. It is not uncommon for healthy individuals to pay Kick up the Cardio!! With Pure Cardio Need a change in your cardio routine? Changing the intensity of your cardio workouts ensures that your body does not reach a plateau. Pure Cardio offers a challenging intensity to condition the heart and lungs while burning more calories. Teresa McMahon, NSCA-CPT Certified Fitness Trainer 503-429-5051 or 503-799-3424 Tuesday & Thursdays from 12-1pm Next full session startsJune 4th! Drop-ins welcome. Terry’s Gym 16720 Noakes Rd Vernonia Gym membership required. more in premiums, high deductibles and copays over a year then what their actual healthcare costs would be if they paid them on their own. We all fear that serious illness or injury that will destroy us financially without health insurance. The impor- tant thing is to be sure that we have the most cost-effective, quality health plan that meets our particular needs. There are options such as catastrophic health plans that come with a higher deductible but often pay for preventive care whether you have met your deductible or not. The premiums are much lower, and in addition, you can open an HSA (health savings account). HSAs provide some tax benefits and money can be removed, without taxes or penalties, for your healthcare costs. They also can rollover year to year, unlike flexible savings accounts. This is one of many options. There is no easy answer to our crumbling health care system and the significant impact that it is having on all our lives. We cannot begin to address the magnitude of this problem or discuss the complexity of this issue in a newspaper column. No one denies that we cannot continue down the path that we are on. We have to de- velop a plan that makes health care accessible and affordable for everyone. It is sad that in a prosperous country with so many resources and technological ad- vances, we lag behind many other countries in areas such as infant mortality, chronic disease and accessibility to healthcare, among others. In our next column we will provide information and tips on how to reduce your healthcare costs. You can send any questions to our email address at the Indepen- dent. We will do our best to answer them or to direct you to the most appropriate resources. Some excellent websites include: *http://www.ahrq.gov/consumer/hlthpln1.htm, www.aarp.org, www.cahi.org, www.ehealthinsurance.com, www.healthinsurancein- fo.net, www.planforyourhealth.com/family/consumer, www.HSAforamerica.com, http://www.consumersunion.org/health/hmo99wc.html An excellent book is: Health Care on less then you think by Fred Brock and Navigating your health benefits for dum- mies/ getting savvy about health benefits by Charles M. Cutler and Tracey Baker. You can also check with Oregon State Department of Health to finding out what op- tions you have for health care coverage through Medicaid. Please contact us with questions or comments: To Your Health, The Indepen- dent, 725 Bridge Street, Ver- nonia, OR 97064, or email: health@the-independent.net. VERNONIA INN Enjoy a quiet weekend with us. FULL SIZE, IN ROOM HOT TUBS Queen Beds • Private Bath • Separate Entrance Cable TV • Phones • Handicapped Access • Commercial Rates FOR RESERVATIONS CALL 1-800-354-9494 / 503-429-4006 Gift Certificates Available 900 MADISON AVE., VERNONIA, OR 97064 Just one block off scenic Nehalem River Hwy. (Oregon 47) Scott Rethwill helps out with free vision screenings dur- ing the Lions Club mobile health screening, on May 12.
