By Maureen Shelly
When Petrona Núñez Montúfar began suffering health problems 10 years ago, she had no experience with the health care system. In the town where she grew up, the local doctor made house calls. But in the city of Scranton, Pennsylvania, were she now lives, it’s more complicated. Petrona muddled through, seeing doctors and obtaining prescriptions, but she still struggled to manage her diabetes and stay positive. The tipping point came when she was scheduled for surgery to remove painful ovarian cysts. At the last minute, she fled the hospital.
Dealing with doctors and medical instructions can be overwhelming. But as you might guess, help is available if you know where to turn. Petrona was lucky to be introduced to Aetna community health worker Rita Cardona, who became her health care guide and “guardian angel.” Through Rita, Petrona learned how health care works, what to expect at medical visits and how to stand up for herself.
Watch a video showing how Petrona got the support she needed to manage her health.
You don’t have to have a community health worker to get the information and care you need. If you’re insured, don’t let it go to waste. This is your guide to dealing with common health situations with confidence.
1. Find the right doctor. In most areas, you have a choice of doctors. For general health care, you’ll need a Primary Care Doctor, or PCP, who can treat routine illnesses and injuries and refer you to a specialist if you need one. Most insurance companies offer online tools to help you find a good PCP near your home or job. Aetna members, for example, can use the Find a Doctor tool, which allows you to filter results by languages spoken, gender, specialty and more. Women may choose a female gynecologist, a doctor who specializes in women’s health, to serve as PCP.
2. Get help with transportation to and from medical visits. If the office isn’t near your home or office, or you have mobility problems, ask your doctor or insurance company about free or low-cost transportation options. Medicaid members can get help arranging travel by bus or car. Other patients may be able to use pretax dollars for transportation through their flexible spending account or health savings account .
3. Prepare for your appointment. The day before your visit, write down everything you’d like to discuss with your doctor, starting with the most important. Include your symptoms, when they began, all your medications (including vitamins and alternative remedies), and your questions and concerns. Find more tips for making the most of your doctor visit.
For Rita Cardona, caregiving comes naturally. Learn how she channels her passion for helping others as an Aetna community health worker.
4. Answer questions honestly. When you see the doctor, it’s normal for him or her to ask about personal issues that can affect your health: diet, sexual activity, relationships, alcohol and drug use, mood, family history or the community you live in. Your privacy is protected by law; the doctor cannot discuss your health information with anyone without your permission.
If you need emotional support, your doctor can refer you to counseling and other mental health resources. Learn more about the overlap between physical and mental health.
Even if your doctor doesn’t ask, make sure to offer information about any traditional medicines or treatments you receive, such as herbal tonics or compresses. Some can interact with prescription drugs.
5. Get the information you need. It’s okay to ask questions, express doubt, make your own medical decisions and expect good communication with your doctors and nurses. Don’t be afraid to find another doctor if you don’t feel comfortable with your first choice.
Consider bringing a loved one to your appointment to take notes. Many doctors will allow a guest or two in the exam room. A second set of ears can help you gather the full context around your diagnosis and treatment options.
You’re also entitled to get a second opinion. Talking to another physician of your choice can make you more confident that you’re getting the right care. Health insurance usually covers second opinions; call your insurance provider before making an appointment to find out about your plan’s limitations. (Find definitions for other common health care terms in the Aetna Glossary.)
6. Learn what to do between appointments. Ask your doctor what’s the best way to get in touch ― phone, email or online patient portal ― in case a question or problem comes up. If you’re diagnosed with an illness or condition like high blood pressure, find out the educational resources that are available. Your insurance company can also help you find out more about your condition and treatment options. Learn how to find reliable health information online.
7. Manage your medications. Contact your doctor if you experience side effects (unpleasant symptoms) from a new prescription. Often, your doctor can lower your dose or change the drug. You can also discuss side effects and alternative drugs with the pharmacist where you pick up your medication.
Talk to your doctor before stopping any medication. Some prescription drugs take weeks or months before you feel better. And a drug designed to offer long-term benefits ― by lowering cholesterol or blood pressure, for example ― may not make you feel any different in the short term. That doesn’t mean it’s not working.
8. Be proactive about your health. According to the World Health Organization, 80% of chronic diseases are preventable. That means eating fresh foods, exercising and not smoking really do help prevent disease. Rod K., who came to America from the Philippines as a young man, says his family back home “didn’t develop the same kind of healthy habits that you do in more developed countries.” After he suffered a stroke at 56, he wished he’d taken better care of himself. Rod K. and other men share their health triumphs and regrets.
Take advantage of preventive visits and tests. It’s normal to see your doctor at least once a year, even if you’re not sick. This is called preventive care, something that isn’t well known or available in some communities. Many insurance companies offer free preventive care visits and tests.
Health care gets easier with every appointment. And Rita says that the more you understand about how the system works, the more you realize that your doctors are there to help you. As for Petrona, she’s now taking her diabetes medication regularly, recovering from her needed surgery, and making progress to achieve other health goals. “Now I’m with her and help her get what she needs.” Rita says. “She seems more happy, more positive in life.”
Maureen Shelly is a health and science geek living in New York City.
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