Health Care Advocacy

How to Be Your Own Health Care Advocate

This guide will help empower you to be your health care advocate. You'll have all of the information that you need about potential providers, and can make smart decisions when it comes time for choosing one who keeps YOU healthy!

Taking Action for Your Health

Physicians and health care facilities are not all the same when it comes to the quality of healthcare. Some physicians may have more knowledge or expertise than others. Some are specialized for a person with a specific health disorder. Likewise, one hospital in your area may have an outstanding reputation. At the same time, another may be linked to a high patient infection rate. There are times when you may need to schedule an appointment with a physician unfamiliar to you or require a hospital stay where you are not familiar with the clinical staff treating you. However, trusting that you will receive excellent medical care from any physician or hospital can feel like playing the lottery.

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Chapter 1. How to Find a Provider

Three of the most common reasons for finding a new provider are: moving to a new geographic area (e.g., moving to another state), changing health insurance coverage, and visiting a specialist beyond your primary care (such as a cardiologist – physician specializing in treating heart disorders). If referred to a specialist physician, your primary care physician may offer recommendations or choose that specialist for you. Something to consider in this case is that you may have health insurance that requires you only to seek care from specialist physicians or hospitals in that insurer’s “network” of providers, or you may be left responsible for the bill.

Whether you choose a specialist or a new primary care physician, you can advocate for yourself by researching possible healthcare providers to understand if this doctor is the best one for your needs. The following are seven things to learn in advance of your appointment with a new doctor.

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Chapter 2. Establishing Goals for Your Appointment

Consider this scenario: your primary care doctor has just referred you to see a specialist physician. Perhaps that specialist physician is a nephrologist (kidney specialist) because you have been having kidney troubles. After doing your research, you scheduled your first appointment.

Now what? 

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Chapter 3. Your Health Insurance (and How Your Insurance Impacts Your Choices)

You may have health insurance from your employer, or Medicaid may cover you. If you are an older individual or an individual with a disability, you may be covered by Medicare. (Even if you are Medicare-insured, you may have enrolled in various parts of Original Medicare or a Medicare Advantage plan – which have different insurance coverage parameters.) Or you may not have any health insurance coverage at all. Hospitals’ insurance and billing policies may be the deciding factor in whether you choose to receive health care services from a particular physician or hospital.

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