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Take charge of yourlong-term health conditions!Tips to get the most out of yourhealth insurance and health careWebinar 4 for Oklahoma employeesNovember 15, 2016This product was prepared with support provided through a grant from theRobert Wood Johnson Foundation’s State Health and Value Strategies program.

Diane Webb, MPH, CHESHealth Literacy Program Manager

MeetLaura and Mika

Poll: What’s the hardest part of taking care ofa long-term health condition?AFinding trusted information about your conditionBUnderstanding what your health insurance plan coversCKeeping costs under controlDFinding a doctor you trustEOther – Type in your chat box

“Take care of your body. It’s theonly place you will have to live in.”- Jim Rohn

AgendaLearn about your long-term health conditionUnderstand your health insurance optionsGet the most out of your health care

AgendaLearn about your long-term health conditionUnderstand your health insurance optionsGet the most out of your health care

Learn about your long-term health conditionAsk your doctorabout your conditionFind trustworthyhealth informationKeep track ofyour health

Ask your doctor about yourhealth conditionGood questions to ask your doctor:1What do I need to do totake care of my health?2How do I do it?3Why do I need to do this?National Patient Safety Foundation, 2016

Laura asks her doctor about diabetesTo better understand type 2 diabetes,Laura asks:o What is type 2 diabetes? Diabetes is a disease where you have toomuch sugar in your bloodo How can I take care of my diabetes? Check the sugar in your blood Take medicine Follow the food and exercise plan

Mika’s doctor prescribes medicineTo better understand his blood pressuremedicine, Mika asks his doctor:o When should I take this medicine? Take 1 pill each morning when you wake upo What are the side effects? Blurred visionConfusionUrinating (peeing) less oftenFeeling dizzySweatingo What do I do if the medicine causesproblems or doesn’t work? Call the doctor’s office if you notice anyside effects

Find trustworthy health informationAsk yourself these questions:1Where is the information from?o Look for websites that end in .edu, .gov, and .orgo Look for materials by organizations with good reputations2When was this written?o Look for information from the last 5 years3Who wrote the information?o Look for articles written by credible health experts4Does the source refer to other credible sources?o Such as National Institutes of Health (NIH), Centers forDisease Control and Prevention (CDC), or university sources

American DiabetesAssociation (ADA)www.diabetes.orgUseful information about:ooooDiabetes basicsLiving with diabetesFood and fitnessEvents and programs inyour community

American HeartAssociation (AHA)www.heart.orgUseful information about:o Basics about highblood pressureo Treatment for highblood pressureo Healthy living tipso Support groups

Keep track of your healthThere are many ways to trackyour healtho On paper, such as a diary or aworksheet from your doctoro Websites onlineo Apps on your mobile phoneDon’t forget to track your familyhistory, too!Create your family health portrait at familyhistory.hhs.gov

Laura tracks her diabetesThis helps Laura learn:Laura uses a worksheetto track:o Foods she eats at each mealo Blood sugar levels beforeand after mealsGlucose Buddyo How different foods changeher blood sugar levelso How medicine changes herblood sugar levelso When her blood sugar levelsare too high or too lowBG Monitor DiabetesBlueLoopFind this record atwww.niddk.nih.gov

Mika tracks his high blood pressureMika uses a worksheet to track:o Blood pressure readingso Where he took the readingo Date and time of the readingHealthThis helps Mika learn:o How his readings change duringthe day and at different placeso How medicine changes his bloodpressureo If he’s meeting the goal hecreated with his doctorSmart Blood Pressure Tracker(Smart BP)Find this log at www.heart.org

Why should I keep track of myhealth information?Tracking your health helps you:o Share information withyour doctor so you cancreate goals togethero Record and see progresstoward your health goalso Take care of your healthcondition between doctorvisitso Get organizedCDC.gov, 2016; HHS.gov, 2016

AgendaLearn about your long-term health conditionUnderstand your health insurance optionsGet the most out of your health care

When you have a long-term healthcondition, it’s important to plan ahead.

Understand your health insurance optionsPick a plan that gives youthe most for your moneyCheck that your doctorsare in-networkTake advantage ofsavings accountsCheck that your medicinesare on your plan’s formulary

Pick a plan that gives you themost for your moneyIf you need a lot of health care, you may save money bychoosing a plan that costs more out of your paycheck.The more money you pay for yourinsurance premium, the less youwill pay for health care services:The less money you pay for yourinsurance premium, the more youwill pay for health care services:

Laura picks a plan with a higher premiumHealthChoice HighPremium: 571.04HealthChoice HDHPvs.Premium: 372.60

Take advantage of health savings accountsWhat are health savings accounts?o Accounts that let you set aside pre-tax moneyto pay for qualified medical expenses: Flexible Spending Account (FSA) Health Savings Account (HSA)How do I enroll in a health savings account?o During the Option Period, you have thechance to enroll in oneIRS.gov, 2016; OPM.gov, 2016

What can I buy with my FSA or HSA?Why should I enroll?o You pay less money in taxesWhat can I buy?o Over-the-counter medicineswith a doctor’s prescriptiono Copays, co-insurance, anddeductibleso Prescriptions, such as insulino Vision care, such as glasses,contacts, and lasiko Transportation to medicalappointmentso Diagnostic careFind a list of what you can buy atwww.ebd.ok.gov/flexible-spendingIRS.gov, 2016; OPM.gov, 2016

Mika picks the HealthChoice HighDeductible Health Plan (HDHP)Mika picks an HDHP because:o He’ll pay a lower premiumo He doesn’t have any plannedmedical expenses besides hisroutine doctor appointmentso He’ll enroll in an HSA to payfor out-of-pocket costs, suchas his medicine

Mika saves money with his HSAWithout an HSAWith HSAYearly salary 40,000 40,000Yearly HSA savings 0 40,000 1,200Taxable income 38,800( 40,000 – 1,200)Estimated taxes 12,000 11,640Take home pay 28,000 28,360Mika’s take home pay was 360 more with an HSA!

Savings ACalculator.aspxUse this to help you:o Calculate how much moneyyou should save in youraccount based on your family’sexpected health care costso See how much money youcan save in taxesEBD.OK.gov, 2016

Check that your doctors are in-networkIn-network providersHealth care providers who contract with your insuranceplan to give you health care services at a lower cost.In-networkOut-of-network You willpay more

Find providers in your plan’s networkTo find a list of in-network doctors andother health care providers:o Visit your plan websiteo Call your insurance companyo Ask family members or friends

Employees ectory/Pages/Default.aspSearch for in-networkproviders by your zip code:o HMO providerso Hospitalso Urgent care

HealthChoice lectProgram.aspxUseful informationabout in-network:o Providerso Medical facilitiesSearch by:o Provider nameo Specialtyo Zip code

Find a primary care doctorA primary care doctor is a doctor who gives you care forcommon health problems and preventing illness. They’ll alsohelp you get access to specialists and special care services.A primary care doctor helps you take careof your long-term condition:ooooSchedule regular visits and testsBuild a relationship with youFind health issues earlyMake referrals to other doctors

Mika’s doctor gives a referralMika’s doctor gives him a referral to see acardiologist, a heart doctor.True or False?Before Mika sees the cardiologist, Mika needs tomake sure the cardiologist is in his plan network.The cardiologist orders a heart testat a hospital.True or False?Before Mika gets the heart test, Mika needs tocheck that the hospital facility is in-network.

Check that your medicinesare on your plan’s formularyTo find out costs for your medicines, find your plan’sdrug formulary online:o Check if your medicine is on the formularyDrug formulary tiersTierDrugCopayTier 1Generic 15Tier 2Preferred brand 40Tier 3Non-preferred brandPay 100% until deductible is met

Save money on your medicineo Ask your doctor or pharmacist for ageneric version or a different medicineo Use mail order for long-term medicinesif your insurance company allowso Ask your doctor or pharmacist forsamples or coupons

Laura checks her formularyLaura’s doctor prescribed:o Metformino Lantus, a type of insulinLaura found the list of diabetesmedicines on her formulary.Are her medicines covered?

Mika saves money on his medicineMika’s doctor gave him a prescription for a medicineto treat high blood pressure called Zestril .To lower the cost:o He asks his doctor for a generic versionZestril costs 484Lisinopril costs 10o He asks his insurance company about mail order130-day supply at his localpharmacy costs 102 90-day mail ordercosts 15

AgendaLearn about your long-term health conditionUnderstand your health insurance optionsGet the most out of your health care

You are the most important memberof your health care team.

Get the most out of your health careFollow yourdoctor’s instructionsBe honest withyour doctorMake sure youunderstand your doctorGet what you need fromyour insurance company

Follow your doctor’s instructionsYour doctor may have you:o Fill a prescription and take medicineo Make another appointment for testso Get lab worko Schedule a follow-up visit and preventive care, such as: Tests Screenings Shots

Laura’s schedule of tests andcheckups for diabetesEvery dayEvery 3 to 6 monthsOnce a yearo Test her blood sugaro Take her medicineo See her doctoro A1c test to see herblood sugar levelsover 3 monthso See her dentisto Wellness checkupo Eye examo Urine (pee) andblood tests tocheck her kidneysand cholesterol

Make sure you understand your doctoro Ask your doctor to explain or re-explain anythingyou don’t understando Take notes during your appointmento Review your medicines with your doctoro Repeat back what your doctor says. You can say:“I thinkwhat youare sayingis ”“So you’retelling methat I needto ”“I just want tomake sure Iunderstand ”

Mika’s unsure of his meal planMika’s doctor tells him to follow theDASH diet for his meal plan. Mika isunsure what this means, so he asks hisdoctor to explain.D DietaryA Approaches toS StopH High blood pressureFind the DASH eating plan /hbp low.pdf

Laura checks that she understandsLaura’s doctor changesher medicine to:o Raise the amount of insulinfrom 10 to 15 unitso Take insulin when she goes to bedinstead of when she wakes upLaura wants to repeat back the instructionsto make sure she understands.

Poll: What can Laura say to repeat back hermedicine changes?ASounds good!BSo you’re telling me that I need totake 15 units at night.CI guess that makes sense, I think I get it.DI think you’re saying my blood sugarlevels are too high.

Be honest with your doctorCommunication is key to building a strongrelationship with your doctor.o Tell your doctor if you: Smoke and how much Don’t always take your medicine when youshould Drink and how much Use herbal remedies or supplements Exercise and how much Forgot to follow the instructions for amedical test

Laura’s medicine side effectLaura has diarrhea after takingmetformin. She’s feels embarrassedabout telling her doctor and insteaddecides to take it only with dinner.At her next doctor visit, her bloodsugar levels are higher than theyshould be. Her doctor reviews hermedicines with her. He asks “How doyou take metformin?”What should she do?