Choosing health insurance? A physician shares these 5 tips

September 15, 2014 | by Nicole White

While health care reform has led to an increase in the number of people signing up for health insurance, many people remain uninsured or are not taking full advantage of the health benefits they now have. Still others are finding that, although their premiums are affordable, they aren't able to see the doctors they want.

Health insurance form Joseph Alvarnas says insurance should do more than fit a price point. Access to doctors and best care matter, especially for cancer patients.

Just because health care is more accessible than before, doesn’t necessarily mean it's less confusing, says Joseph Alvarnas, M.D., director of Medical Quality and Quality, Risk and Regulatory Management at City of Hope.

“You have to realize we’re in un-navigated waters,” Alvarnas said. “We’re here to serve not only as health care providers, but educators. We need to empower people to be active participants in their care.”

Alvarnas, a hematologist, conducts research into sustainable models of health care.

“Value needs to be more than just a function of cost,” he said. “We also have to consider innovation, quality, access, relevance. We have to be careful not to put cost as the key litmus test for what’s meaningful.”

As open enrollment for health insurance approaches – both for people using medical exchanges under the Affordable Care Act and for people choosing health insurance through their employers, Alvarnas offers the following tips:

Don’t be intimidated into not acting. Many people are so afraid or confused of the health system, they simply do nothing, Alvarnas says. You are your best advocate.

Begin a conversation with your family and your doctor. You don’t have to figure out your care on your own, and your doctor can – and should – be part of the conversation about your health care plan decisions. Your doctor can also guide you in figuring out what level of care you’re likely to need, and what potential health risks you want to be prepared to confront.

Details are important. Price is, of course, a factor everyone must consider when purchasing health insurance. However, make sure the coverage you’re purchasing will allow you to continue your relationship with your physician – or that you have a plan to find a new doctor.

Know what your plan covers. While access to specialty care isn’t necessary for every ailment, those who have chronic conditions or who are at higher risk of serious disease should consider carefully which plans they choose. “You want to know who can offer novel treatments, who offers more effective therapies, and has better survival and outcomes,” Alvarnas said. Medical centers are increasingly transparent, and – like City of Hope - frequently offer this data online.

Data presented at American Society of Clinical Oncology this past spring show that patients treated at National Cancer Institute-designated comprehensive cancer centers, like City of Hope, have higher survival rates and better outcomes than patients treated at community hospitals. The difference in five-year survival rates was especially dramatic for patients with the most deadly cancers, even when controlling for such factors as socioeconomic status, age and gender.

Once you have access to care, use it. Alvarnas points out that much of the power of the Affordable Care Act is in preventive care and screening. Colonoscopies and mammograms are available without additional cost. “But these services aren’t useful if people don’t avail themselves,” Alvarnas said. “Use them to your benefit.”

Where you receive care matters – and that should be a consideration in choosing your health plan. Make sure your plan allows access to care at City of Hope.

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Learn more about becoming a patient or getting a second opinion at City of Hope by visiting us online or by calling 800-826-HOPE (4673). City of Hope staff will explain what's required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.

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