Taking Charge of Your Healthcare

  • Young men's version of this guide

So you are growing up and gaining the new responsibilities that come with getting older!  Now, if you are feeling a bit overwhelmed, take a deep breathe, that can be normal. Learning how to advocate for yourself without the help of your parents/caregivers can be an intimidating responsibility, but remember with the right tools, you can succeed!

Appointments with Your Healthcare Provider

How do I schedule an appointment with my healthcare provider?

If you are an established patient, meaning you have seen the health care provider (HCP) before, then you can call the office and request an appointment. The staff will ask what dates and times work best for you. Then they will see if the provider has any appointments that match with your schedule. Once you have confirmed your appointment, it’s a good idea to put it in your calendar and set a reminder in your phone, so you remember. Some offices allow you to set-up appointments online or through a health care portal.

If you have to reschedule your appointment, you should call your healthcare provider right away. If you miss your appointment or cancel too close to your appointment date, you might receive a bill for a missed appointment.

If you are a new patient calling to schedule a new patient appointment. The staff may ask some additional questions such as your name, date of birth, address, insurance plan, etc. It’s a good idea to have this information available in case these questions come up.

Does my parent/guardian have to accompany me to my appointments?

If you are a minor, meaning you are under the age of 18 years old, your parent/guardian may need to accompany you to the visit. When you call to schedule your appointment, tell the staff how old you are and ask (based on your age) if a parent/guardian needs to be present for the visit.

Do I need insurance?

In the United States, at a federal level health insurance coverage is not mandatory; however, in some states it is. This means that the United States does not offer universal health coverage (UHC). Some countries have UHC, such as the United Kingdom, Ireland, Italy, Canada, Australia, China, Ghana, and many others. In these countries, each citizen is entitled to free and equal health care. However, in the U.S. citizens are required to either pay their employer for coverage or purchase their own health insurance coverage, which can be costly.

In the United States, each health insurance plan is different, so it is a good idea to have a conversation with your parents or legal guardian. They should know the details regarding their plan such as what is covered verses what’s not. Depending on the plan, if you are under the age of twenty-six years old, you may be covered under their health insurance plan. If not, you may be able to purchase a lower-cost health plan either through your colleges or university, your state’s health connector website, or your employer.

What is a copay?

A copay is a fixed fee that you pay each time you go to see a healthcare provider, pick up prescriptions, or go to the emergency room. The amount you pay is different depending on the health insurance plan and type of visits. For example, if you go to see your healthcare provider because you have a sore throat, your copay might be twenty dollars verses when you go see your healthcare provider for an annual physical your copay may be zero dollars. The amount and frequency of copays have to do with your individual health insurance plan.

It’s likely that the policy holder (the person who pays for the insurance) is familiar with copay amounts. However, if you are curious, most insurance plans write the amount for each copay on the insurance card. If you can’t find the copay amount on your insurance card, try giving your insurance plan a call, a representative will ask for the insurance ID number and additional information that can be found on your card. Once they have that information, they can help determine whether or not your healthcare provider’s office will request a copay.

If you ever get stuck in a bind and you don’t have cash or a credit card to pay for your co-pay, the healthcare provider can bill your insurance. Once that happens, your insurance company will send you a bill for the copay and you can pay it then. You can also ask your healthcare provider if their clinic/hospital offers financial assistance or payment plans.

Will I receive a bill for my visit after the appointment?

It really depends on your health plan. Each health plan has different copays for visits as well as charges for medications, lab work, and diagnostic testing (like X-rays or ultrasounds). Plans also have an out-of-pocket maximum amount, which means the most you will have to pay per year is the maximum amount. Once you pay the out-of-pocket maximum, any additional health insurance bills will be covered by your insurance. Some people will reach their out-of-pocket maximum in March, others in November, and some never reach their out-of-pocket maximum.

If you are worried about receiving a bill, then there is no harm in calling your insurance company before your visit. They can help you determine what will be covered by your insurance and what you’ll need to cover on your own after the visit. You can also request the bill be sent directly to you if you’d like.

How do I get a medication refill?

There are a few different ways you can go about refilling a prescription. Start by reading the label attached to the medication, this is your prescription. It should have all the information you will need to refill the prescription. If the prescription shows that there are refills available (i.e. “refills: 2”), you can refill it either in person or over the phone at the pharmacy. The pharmacy’s phone number and address are usually on the prescription.

If your prescription does not have any refills left (i.e. “refills: 0”), then you will need to call your HCP to request a refill. In some cases, your HCP’s office may require you to schedule an appointment first, before they give you a refill. This is simply so that the healthcare provider can make sure that the medication is working for you.

How do I help on the weekends or at night?

Most clinics will have a provider on-call who covers nights and weekends when the office is closed. This way patients can contact the provider on-call if they are not feeling well or have a non-life threatening emergency. It is usually a good idea to call the provider on-call first, before going to an urgent care center or emergency room, unless it’s a life-threatening emergency (i.e. such as if you can’t breathe or have severe pain), then call 9-1-1. Calling the provider on-call, may help you get the medical advice you need without having to go wait in an emergency room or urgent care!

The provider on-call can often be reached by calling your HCP’s office. In most cases, the provider’s office will have a recording that will give you instructions on how to reach the provider on-call. Sometimes, the provider’s office will have an answering service, where you will leave a message and someone will call you back. It’s important to pick up your phone when they call back. Also they may call from a blocked number.

What if I want my health information to be confidential?

Confidentiality is an important part of healthcare and your relationship with your provider. You, as the patient, need to have trust and confidence in your HCP. You should feel comfortable in your ability to share personal information with your provider, as well as ask questions.

If you are under the age of 18 years old and a parent/guardian accompanies you to a visit. It is common for most HCP’s to automatically ask parents/guardians to step out of the room during a part of your appointment. This gives you time to ask questions or answer questions truthfully without feeling awkward or embarrassed in front of your parents/guardians.

If your provider doesn’t do this and you don’t feel like you can have an open conversation with your parents, call your HCP office. Let the office know that you’re planning to come in for an appointment, but that you have some questions you’d like to ask without your parents/guardians in the room. Your provider can act as a great buffer between you and your parents/guardians.

During your appointment, ask about your provider about their confidentiality policy. You need to know if personal information is kept private unless your provider believes there is a danger to you or to others, that you are being abused, or that you are not able to make safe decisions.