Prevention is Key- Part 1

Hello Health Care Transformation Tribe!

Today I’d like to chat about one of the most important things you can do for yourself in order to have the best health at the lowest price and that is PREVENTION! Prevention means stopping something from happening in the first place.

Many expensive and painful diseases are actually caused by ourselves, not our genetics. For example, obesity due to overeating and lack of exercise causes us to have diabetes and heart disease. Smoking causes lung cancer. Excessive alcohol drinking causes a myriad of body problems including liver disease, GI problems, and osteoporosis.

So as you can see, it is actually very much in our control to keep ourselves healthy now so that in the future we don’t have to deal with a crappy, painful, expensive disease.

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So what are my key tips for staying healthy and preventing disease?

Let’s start with healthy eating. Some of my key recommendations that I practice are below and you can find more in My Health Care Transformation Handbook:

  • Grocery shop on the periphery of the grocery store. I steer clear of aisles as much as possible! (But also be sure to steer clear of the bakery…)
  • Eat foods that are found in nature, not made in a factory. Carrots are found in nature. Cheetos came from a factory.
  • Go to your local farmers market or utilize a market delivery service. My favorite fresh local delivery service is Grubmarket in LA but I love to head over to the Brentwood Farmer’s Market any Sunday that I can.
  • Don’t store foods from the “avoid list” in your home. For example, I don’t store any desserts in my home. If I want a dessert then I need to walk out of the house and get it. And then guess what. I hardly ever eat desserts 😉

Now second to healthy eating is exercising. Here are some of my key recommendations that I practice and, again, you can find more in My Health Care Transformation Handbook:

  • Incorporate exercise into your day as much as possible. For me, I make sure to walk or bike anywhere that is within a few miles. I bike to the office. I take the stairs up and down whenever it’s less than six flights. Stay active!
  • Sign up for a workout class at the beginning of the week – then you can’t bail out that day when you are feeling tired! For me, I plan all my workouts, whether that is running, dancing, yoga, HIIT class, at the beginning of the week so that it is already scheduled and I make my plans around working out.

Also of extreme importance is taking care of your mental health. Having a happy, healthy mental state will help you achieve balance in your nutrition and exercise and vice versa. My key recommendations on how to achieve your best mental health, with more being available in My Handbook:

  • Document what brings you joy and then manage your time to ensure you are making room for these things. For example, I know that the top things that bring me joy are building relationships and friendships, exercising, being outdoors, and, of course, educating people on health care. So I make a concerted effort to make plans with friends as much as possible, exercise and be outdoors daily, and work on Health Care Transformation as much as possible.
  • I highly recommend setting some goals and then thinking through any mental barriers you are creating to achieving those goals of living your happiest best life.

And finally, practice healthy habits. Limit your alcohol intake and I don’t think I need to tell you that smoking is bad for you… But I will… Smoking is bad for you.

Now that we have talked through the basics of prevention, take some of these recommendations, set some goals for achieving your best health, and we will chat more about prevention soon!

Cheers to Health and Happiness!

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Health Care Navigation

It’s National Healthcare Decisions Day!

Happy National Healthcare Decisions Day!!!

Wait… you didn’t know it was today?? And you don’t even know what that means??

Well then let me explain because this is really important and this is an area of health care I’m very passionate about!

The goal of National Healthcare Decisions Day is to educate and empower all individuals and doctors to complete their advance care planning.

So what is advance care planning?

Advance Care Planning means planning in advance for medical decisions just in case you are so sick that someone else has to make the decisions for you. These are your decisions to make based on your values, preferences, and conversations with loved ones.

Advance care planning is really important for the following reasons:

  • We are all mortal but prior to our time on this earth ending, we have incredible feelings, goals, and preferences on how we want our final time to play out. Some people would be happy never being able to taste food or walk again as long as they are alive. Other people would rather die than be stuck in a home in front of a TV with tubes for eating and going to the bathroom. Since you are an individual human you have your own desires and we need to make sure your family and doctors are aware of these.
  • The default of our medical society, unfortunately, is NOT to proactively have these conversations with you and your loved ones (although this is slowly changing). And then when the time comes when there is an urgent issue and no medical professional is aware of your wishes, they provide really aggressive medical care. Think surgeries and rib-breaking chest compressions and electrical shocks and tubes down throats. Now sometimes that saves a life but sometimes it actually can hurt an individual who is elderly or can be quite a shock and disappointment for those who want to die peacefully at home at the end of their life.

This Frontline episode “Being Mortal” will give you an inside look into the health care system and will really help you understand the importance of advance care planning.

So what should you do? Follow the checklist below that’s taken directly from My Health Care Transformation Handbook (available for purchase soon!) You might be the individual who needs to complete these steps or you might need to support your parents and grandparents in completing these steps. Either way, we can’t predict the future so we want to be sure that the family is as prepared as possible for whatever may come our way.

Advance Care Planning Medical Checklist:

  • Self-reflect on My Goals of Care
  • Discuss My Goals of Care with my family and friends
  • Discuss My Goals of Care with my Primary Care Provider (PCP)
  • Discuss My Goals of Care with the rest of my Care Team
  • Complete my Non-Temporary Advance Directive
  • Complete my Physician Order for Life-Sustaining Treatment (POLST) Form
  • Have my doctor scan copies of my documentation into my medical record

To learn more about Advance Care Planning, the Navigating the U.S. Health Care System 101 course has two lessons on this topic! And like I mentioned, My Health Care Transformation Handbook will be coming soon with an entire chapter to support you and your loved ones with advance care planning so stay tuned for more info!

In the meantime, check out this comprehensive list of more resources on advance care planning.

I hope today you take this opportunity to have open honest conversations with your family and other loved ones about your goals, wishes, and preferences in the face of an unforeseen event.

Cheers to your every health and happiness.

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Health Insurance

Health Insurance 101- Intro to Benefits

Hey Guys and Gals! I’m sure you’ve been waiting in anticipation to learn more about BENEFITS!!

Before we get started, here is the quick recap of the three health insurance essentials so you can see where BENEFITS kicks in.

Three key essentials:

  • Cost Sharing
  • Benefits/Coverage
  • Networks

The gist: you need to find a health insurance plan that includes the BENEFITS, or medical services, that you need with the NETWORK of doctors and hospitals that you want to see with a COST SHARING setup that fits your budget.

Benefits/Coverage: which medical services you can receive that will be covered under the health insurance plan, or in simplified terms, what you get for your $$$.

Benefits that are covered in your insurance plan will range from who is providing the service (midwives, physical therapists, chiropractors, etc.) to where the service is provided (in the hospital vs outside the hospital in a clinic, skilled nursing facility, etc.) to how long the service can be provided (length of hospital stay for having a baby).

And where can you find all these details??

Summary of Benefits and Coverage– remember that document we talked about a couple weeks ago? This document, even though it looks incredibly daunting, is your best health insurance friend because it tells you what is covered and what it will cost! It will feel like reading the ingredients on a nutrition label or your prospectus when investing- it’s not exciting and there are going to be terms you won’t know but use Google and ask friends and read it because IT’S IMPORTANT! 

Key tip to remember: Your COST SHARING is directly related to the size of your BENEFITS and your NETWORK. If you need or want more BENEFITS to be covered by your health insurance plan, and potentially the option of a larger NETWORK of doctors and hospitals, your COST SHARING will go up accordingly.

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Now many of you have been asking me how to best take advantage of your benefits and my recommendation is this: Take advantage of your free annual preventive visit with your doctor. Most of you should have this with your insurance plan (or should select an insurance plan with one) and it’s important you use it!

Any question about BENEFITS? Comment below and as always…

Cheers to Health and Happiness!

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Health Insurance

Health Insurance 101: Intro to Networks

Hey Guys! Quick recap on what you should already know before we hit the ground running on NETWORKS. 

There are three essential components you should know and feel comfortable with when selecting a health insurance plan:

Three key essentials:

  • Cost Sharing
  • Benefits/Coverage
  • Networks

The gist: you need to find a health insurance plan that includes the BENEFITS, or medical services, that you need with the NETWORK of doctors and hospitals that you want to see with a COST SHARING setup that fits your budget.

Networks: the doctors and hospitals that will be covered and will “accept” your insurance plan, or in simplified terms, who you can see for less $$$.

Like I said… it’s very important that you review the network of doctors and hospitals included in the health insurance plan to make sure it includes the doctors you want to see.

Let me give you an example that I went through when selecting my dental plan…

My dentist is Dr. Ted and I’ve been going to him for years. Dr. Ted is the BEST dentist around- he’s friendly, he’s funny, he’s motivated by helping people, and heck I’ve never gotten a cavity (knock on wood!) Now when I started a new job and had to select my dental plan I had two options- HMO or PPO. So what did I do? I checked to see if Dr. Ted was in both networks. PPO networks are typically much larger than HMO networks and it turns out that Dr. Ted is in the PPO network but not the HMO network. Conclusion made– I’m selecting the PPO because for me I would rather pay more money for the PPO and get the high-value service from my current dentist who knows my teeth well.

The same applies to any plan you select, whether health insurance, dental, or vision insurance!

Make sure your doctors are -in network-

Now, this doesn’t limit you from seeing doctors who are “out-of-network”. Most of those doctors will still see you but if you are in an HMO you typically become a cash-paying patient where you have to pay for all services by yourself (“out-of-pocket”- remember that term??) with no help from the insurance plan you are currently paying for. If you are in a PPO the insurance may still cover some of it but it will be much more expensive than seeing an “in-network” provider.

Any questions on NETWORKS? Feel free to comment below and I look forward to seeing you next time when we chat about BENEFITS!

Cheers to Health and Happiness!

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Health Insurance

Intro to Health Insurance 101

Hello Ladies and Gents! It is officially that time of year (not just the flu season…not just the holiday season…) but it’s time to select your insurance plan for the 2018 calendar year!! Very exciting stuff!

Now I’m sure you must be looking at the options and thinking… “What the heck do these words mean?” “Which plan is the most cost-effective for me and my family?” “Which plan is going to cover the health care that I need?” Maybe you are even thinking “Where the heck do I even start??”

I’m here for you!!! 

Throughout the next few weeks I will post about the basics of the health insurance system so that you feel more confident in the decisions you are making about which health insurance plan to select.

First important point to make:

Make sure you have health insurance! Just one accidental hospitalization can cost up to six figures so if you don’t have that money in the bank you should get health insurance!

Hopefully someday soon it will be easier for everyone to have health insurance but right now it is still really tricky. Here are some recommendations based on your potential situation:

  • If you work for a large employer that’s great- you can take the offered insurance and cover as many members of your family that you can.
  • If you are under 26, you can have your parents claim you on their health insurance. The only requirement is age so don’t worry if you don’t live with them, are married, etc.
  • If you are not offered insurance through your employer, you can go to your state’s health insurance exchange website. (See links below)
  • If you are an independent young adult who is not offered insurance through your job or your parents and you are very healthy, you can go onto your state health insurance exchange website, just like I mentioned, but you can opt for a very lean health plan that is inexpensive. That way you are covered if something should happen and you avoid the tax penalty at the end of the year for not having insurance.
  • If you are over 65 or have kidney failure, sign up for Medicare!
  • If you are not offered insurance through your employer and are having trouble financially affording health insurance, you can check your state’s Medicaid requirements. You may be eligible for insurance based on your current situation. If you have children, they may be eligible for the Children’s Health Insurance Program (CHIP).

Here are some links to help you navigate purchasing health insurance if your employer doesn’t offer it: -This site will lead you to your state-based health insurance exchange that I mention above. Click on “Find Local Help”. -Here’s where you can sign up your parents, grandparents, or other loved ones for Medicare. -Here’s the site where you can learn about Medicaid and CHIP and whether your current financial status allows health insurance coverage for you and your family.

And on a side note, you might be wondering about this tax penalty…

The concept here is that all individuals across the country should have health insurance- both for their own health but also for the sake of the risk pool and societal contribution (which I’ll explain in a different post once we get through the basics).

If you can afford health insurance but choose not to buy it, you may pay a fee called the individual shared responsibility payment. This is typically called the “tax penalty” or “individual mandate.”

For the 2017 plan year, the fee is calculated 2 different ways – as a percentage of your household income or per person. You’ll pay whichever is higher. The fee is 2.5% of household income or $695 per adult + $347.50 per child. 

Ok, everyone! It’s time to get out there and purchase your 2018 Health Insurance Plan! The market closes in December!

This is just the beginning of the Health Insurance 101 series so please feel free to send questions below or through the website contact page so I can be sure to address them in future blogs. Together we can simplify the health insurance complexities!

Cheers to Health and Happiness! 

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