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Top 10 Ways to Healthcare Consumer Empowerment

Consumer empowerment, a growing method of healthcare management for employers and healthcare organizations, involves empowering yourselves by learning how to become wiser healthcare consumers.

The following 10 ways, suggested by California-based MetraHealth Care Plan, can help you learn more about your healthcare and use of healthcare services:

1. Establish a relationship with a primary physician -- before you need one. The more your doctor knows about you, the better care you are likely to receive when you're ill. Be honest and thorough in talking with your doctor about your health, your lifestyle and your personal and family health history.

2. Ask questions. You have the right to ask your doctor what a procedure involves, how much it costs and if it's medically necessary. Ask whether equally effective, less costly alternatives are available.

3. Learn how to practice self-care. More than 80 percent of all health problems can be cared for in the home. You should learn how to recognize common health problems, what to do when they occur, when and where to seek appropriate help, and how to prevent health problems from recurring.

4. Check your Provider Directory, if you participate in a health maintenance organization, preferred provider organization, etc. Make sure a provider to whom your physician refers you participates in your health plan. It's a good idea to call the provider's office for verification.

5. Know your prescriptions. Make sure you tell your doctor and pharmacist about all drugs prescribed to you, so they will know if a new drug may have possible unfavorable interactions with those you are taking.

6. Use the emergency department for medical emergencies only. Emergency department care is many times more costly than care provided in a doctor's office. However, if you feel your health or life are in jeopardy, you should go to an emergency department immediately.

7. Learn about your illness. Ask your physician for information about special diets or physical activities that would be helpful. If you are on medications, ask about possible side effects.

8. Carefully read your Certificate of Coverage and Summary of Covered Benefits. Know and understand your healthcare benefits. If you're not sure a service or procedure is covered, refer to your benefits materials or call member services.

9. Review bills carefully. If you're in the hospital, have a friend or family member keep track of your tests, medications and supplies you use — or do it yourself if you feel up to it. After you leave the hospital, ask for an itemized bill and compare the charges with your records.

10. Live a healthy lifestyle. Eat a sensible diet; wear your seat belt; obtain recommended preventive care; perform monthly breast or testicular self-exams; get enough sleep; don't smoke; exercise at least three times a week; and, if you drink alcoholic beverages, do so in moderation.

Address: MetraHealth Care Plan, 4500 East Pacific Coast Highway, Long Beach, CA 90804; (800) 875-4206.

Copyright 1999 Health Resources Publishing

© 2000 Health Resources Publishing