Tag Archives: Urgent Care

National Financial Wellness Month

National Financial Wellness Month

It’s National Financial Wellness Month, and we have tips about taking care of your finances, especially as they relate to health insurance.

Using Your FSA

If your health insurance features a flexible spending account (FSA), you could save on all kinds of health services and products.

Your FSA and the New Year

 

Health savings accounts (HSAs) are becoming more common, and if your plan has one, it could help you with your medical expenses and offset high deductibles. 

Saving with an HSA

 

You might not realize how much money you’re losing going to the emergency room when you should be going to urgent care. Know where to go and save.

Skipping the ER

 

You know you pay a premium for your health insurance, but do you understand all of your out-of-pocket costs, like deductibles, copays, and coinsurance? Make sense of what you pay.

Paying Out-of-Pocket Costs

 

Do you know what happens after you get care? Make sense of the claims process, how your doctor gets paid, and what you’ll owe.

Paying Healthcare Costs

 

Making financial plans for your future can help you be ready for retirement, Medicare, and medical emergencies. Be prepared.

Making Financial Plans

 

Financial wellness can impact other parts of your health too. These tips can help you track your spending, set goals, and more.

Safe Travel Each Step of the Way

Safe Travel

Summer travel season is upon us, and preparing for safe travel is important, especially if you have an illness.

First, learn about your destination to check for any local health notices or immunizations you might need first.

Safety Wherever You Go

 

Think about your health before you book. From illness and surgery recovery to pregnancy, check if you’re safe to fly.

Fly Smart

 

See a doctor before you take off to make sure you’re up-to-date on key shots or healthy enough for planned activities.

Vaccines for Travel

 

Pack carefully to protect yourself, especially if you need medicines or care while you’re traveling.

Pack for Your Health

 

Be prepared for the signs and what to do if you know you’re at higher risk of health issues while traveling.

Healthy and Prepared on Vacation

 

Make sure your family or friends (and government entities depending on where you’re traveling) know your travel plan.

Share Your Travel Plan

 

Know you’re covered with a copayment or coinsurance for ER and urgent care if you get sick while traveling.

And check out Assist America, which helps connect you to services when you get sick while traveling.

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In Case of Medical Emergency

Long View: What Is a Medical Emergency?

According to Medicare.gov, a medical emergency is a situation where “[Y]ou believe you have an injury or illness that requires immediate medical attention to prevent a disability or death.”

It seems pretty straightforward, so why are there so many questions around the decision to get treatment at your local emergency room?

An emergency room (ER) provides some of the most sophisticated diagnostic options in a hospital and the most immediate care to patients in crisis.

The list of possible emergencies is endless, so it’s important for you to recognize how serious your injury or illness is and to know the best way to get treatment for it.

Many of us have heard about folks with medical emergencies driving themselves to get treatment or catching a ride with a family member. Please don’t. Driving yourself puts you and others in jeopardy and delays the start of your treatment. Dialing 911 brings you the treatment quickly and gets you to an emergency room faster than a white-knuckle trip across town, dodging traffic lights.

Dr. Frank Friedman, one of our medical directors who specializes in emergency care, said, “A true emergency is one that can’t wait. It is something causing such severe pain or such a risk to life or limb, for oneself or a loved one, that it can’t wait hours, or a day or two, to be seen by one’s own doctor or healthcare provider.”

If it’s not an emergency but you need medical care to keep an illness or injury from getting worse, call your doctor. If your doctor can’t see you right away or the office is closed, urgent care (or convenient care) can help you get treatment quickly.

Over the years, I have heard some interesting and alarming questions from our members. This FAQ can help answer those questions.

Q. I just got one of your policies, and I’m having severe chest pain. Will you cover me for an ER visit?

A. This is one of the most unsettling questions we receive. If you’re experiencing severe chest pain, don’t call your plan, call 911. It’s as simple as that.

Q. Do I have to pay a copay when I get there?

A. No, they should be able to bill you, so there’s no reason to wave your credit card around as they wheel you through the front door. In fact, under federal law, an ER has to evaluate and stabilize you in an emergency medical situation, without regard for your ability to pay.

Q. What if I have special conditions they need to know about?

A. Keep a list of your medications with you. MedicAlert’s medical IDs or the Yellow Dot program can also help you share this information. And many smart phones have features that let you add emergency contacts and medical information. Plan ahead.

Q. What are some examples of when I should go to the ER and when I should go to my doctor or urgent care?

A. Visit the ER for emergencies like chest pain, broken bones, poisoning, shortness of breath, fainting, and seizures. For things like a constant fever, strep throat, sprains, the cold or flu, earaches, or minor infections like pink eye, call your doctor or visit urgent care.

Will you recognize a medical emergency? Probably yes, so trust your judgment, act quickly, and please be careful out there.

Patrick Harness is a community liaison with a long history of experience in health insurance. If you ask him to pick a color, he always chooses orange, and he is known for his inability to parallel park.

Medicare Advantage Mythbusting

Long View: Medicare Advantage Truths Might Just Change Your Mind

As I travel around the Illinois countryside, I hear the same misinformation about Medicare Advantage over and over. To tackle some of that, here’s a Q and A.

Question: When I join a Medicare Advantage plan do I lose my Medicare coverage?

Answer: No. If you have a Medicare Advantage HMO or PPO plan, a private health insurance company that has a contract with Medicare, like Health Alliance Medicare, provides the services instead of Original Medicare. People who disenroll from Medicare Advantage plans revert to Original Medicare. In either case, no one loses Medicare coverage.

 

Question: Will I be able to stay with my current doctors?

Answer: Probably, especially with Health Alliance Medicare. That’s why it’s important to check any plan’s provider directory to confirm your doctors work with the plan. People who select a Preferred Provider Organization (PPO) plan can use out-of-network providers, but they typically pay more when they receive services.

 

Question: We travel and might need to use the emergency room. Will Medicare Advantage plans only cover me for emergency care when I’m close to home?

Answer: No. Medicare Advantage plans cover out-of-area emergency and urgently needed care.

 

Question: If something serious happens and we need lots of services, could we predict how much we would pay for care?

Answer: Yes. Medicare Advantage plans have an annual Out-of-Pocket Maximum (OOPM), also called a Yearly Limit. When a Medicare Advantage member reaches that limit, the health plan pays 100 percent for Medicare-approved services. This amount doesn’t include the premium and other limited expenses. You can estimate what your expenses would have been last year on the Medicare Advantage plan you are considering.

 

Question: Medicare Advantage sounds good for me, but wouldn’t the premium be too costly for my 88-year-old mom?

Answer: Not at all. One of the best things about Medicare Advantage plans is the premium is the same no matter the member’s age. You and your mom would pay the same monthly premium if you had the same plan, unless either of you could get extra help paying for coverage based on your income.

 

Question: Would I have to deal with all the paperwork I get when I receive services from Original Medicare plus a Medicare Supplement plan?

Answer: No. You would have much less paperwork with a Medicare Advantage plan. In fact, that’s one reason Medicare Advantage plans exist, and I’m all for less paperwork.

 

Remember, the Medicare Annual Enrollment Period, or AEP, runs from October 15 to December 7. That’s the only time most people can change their coverage for the following year.

If you are thinking about a change for yourself or a loved one, you will have to do a bit of research. Trusted resources like Area Agencies on Aging and your local senior center can help.

Please consider Health Alliance Medicare a resource, too.

We all want to make well-informed choices that don’t depend on myths and misinformation.

In Case of Emergency

ER Care vs. Urgent Care

Your 2-year-old has an earache. You slip and sprain your ankle. You’re feeling chest pain. Do you know where you should be getting care in each of these cases?

It can be hard to know, but it’s important because if you go to the emergency room when it’s not actually an emergency, your insurance may not pay for your care.

A trip to the ER is usually the most expensive kind of care. The average ER visit costs more than the average American’s monthly rent.

If you don’t need help right away, you can save time and money by setting up a same-day appointment with your doctor or going to an urgent care or convenient care clinic. These usually have extended hours, you don’t need an appointment, and many clinics have them.

But when something happens and you need care right away, you should know which things you should go to an urgent care location for, and when you should go to the ER.

Emergency Room or Convenient Care?

Earache

Visit convenient care. This needs care to keep it from getting worse, but it won’t pose a serious health risk if not treated immediately.

Sprained Ankle

Visit convenient care. This injury isn’t life threatening, but you may need medical attention to treat it.

Chest Pain

Go to the ER. This could because of a serious problem and is normally considered a medical emergency.

A trip to the ER is usually the most expensive kind of care. If you don’t need help right away, you can save time and money by setting up a same-day appointment with your doctor or going to an urgent care or convenient care clinic. These usually have extended hours, you don’t need an appointment, and many clinics have them. Carle, for example, has a few convenient care options.

Let these examples be your guide to where you should go:

Emergencies

Urgent Care Situations

  • Shortness of breath
  • Chest pain
  • Poisoning
  • Broken bones
  • Fainting, seizures, or unconsciousness
  • Sharp wounds
  • Serious bleeding
  • Constant high or rising fever
  • Migraine headaches that don’t improve
  • Uncontrolled vomiting or diarrhea
  • Bronchitis
  • Severe allergic reactions
  • Cuts, even minor ones, that need closed
  • Constant high or rising fever
  • Migraine headaches that don’t improve
  • Uncontrolled vomiting or diarrhea
  • Bronchitis
  • Allergies and asthma
  • Cold and flu
  • Minor infections, like bladder, sinus, or pink eye
  • Rash or sunburns
  • Sprains and strains
  • Back and neck pain
  • Muscle or body aches
  • Earache
  • Strep throat
  • Minor cuts
  • Minor work illness or injuries

 

It’s not always easy to know if you should go to the emergency room, especially when you need to act fast. The key is to trust your judgment. If you believe your health is in serious danger, it’s an emergency.