Navigating the System

Empower yourself as a patient, and learn how to get the most out of your benefits. Each plan is different, so this section of our guide will help you understand what it is that you should look for when you receive your insurance information.  This section will help you navigate the health care system when you need care.

Topic Area: Making the most out of your coverage

How do I make the most of my doctor appointment?

Spending a little time to prepare before you go to the doctor can help you get what you need from the visit.

Think about why you are going to see the doctor  

  • Annual wellness check: Focus questions on how to keep healthy. If you bring up specific health problems, that may change the focus of the visit and how the doctor bills for the type of service. Be aware that the amount your insurance covers and the amount you will pay depends on the type of service provided.   
  • First visit: Be on time or early. You will probably have new patient paperwork to fill out. Bring your photo identification, a list of all medications and supplements, and your insurance coverage information. Ask if any tests will be done and if you need to do anything for the tests, like not eating.
  • On-going care: Tell your doctor about any changes since your last visit including emergency care, changes in health, or life changes. Talk to your doctor about any problems with treatments or medications.
  • Symptom related: When you see the doctor for a specific problem like an injury or the flu, focus on your treatment options. Ask questions about tests and alternatives. Learn more.

Be sure you understand what your insurance coverage is for each type of office visit and confirm that the provider is in-network to avoid unexpected costs.

Make your appointment productive

Have questions ready: It’s easy to forget questions when going to the doctor. Write them down to keep this from happening to you. Think about which questions are the most important to you. Take a note pad with you to help remember answers.

Be honest: Your healthcare provider needs to know what is really going on with you provide the best care, so tell your doctor the facts.

Ensure understanding: Ask questions if you are unsure about what the doctor is telling you. If it would help, think about asking a friend or family member to go with you. Ask for educational materials or references on your condition or treatment.

Before you leave

  • Ask if you need a follow up appointment. If yes, schedule before you leave.
  • Understand warning signs for your condition or treatment that you should watch for and who to call if they happen. 
  • Know who to contact in the office about new prescription concerns. 
  • Ask for office contact information and the best way to ask questions, whether by phone or email.  Find out how long it typically takes to get an answer to questions.
  • Ask questions if you don’t understand your diagnosis or treatment plan.

Tools to help

Health record:  Consider tracking your health information in a personal record. There are free electronic tools (such as Evernote and MyChart). These tools can help you keep track of your health and use when talking with your doctor.

National Institutes of Health tools:

Recording Your Family Health History

Changes in Health worksheet

Prioritizing your questions or issues for your appointment

Medication and supplement tracking

Medical Tests: The National Library of Medicine's MedlinePlus website can help you understand your medical tests.   

Questions to ask about medical tests

  • What tests are needed?
  • What will the test show?
  • What will the test cost?
  • What preparation is needed for the test?
  • Where will the test be done?
  • Are there any risks or side effects?
  • How soon must the test be done? 
  • How and when you will be notified of the test results?
  • Are there alternative choices for the test?

6/10/2024

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