Janine Haar, Elizabethtown College’s health consultant from Benecon, and Capital Blue Cross Benefit Specialist Dana Cassel presented “Know Your Benefits,” the first of a series of discussions on utilizing health benefits.
Haar first explained how the cost of emergency care has risen recently to deter people from visiting emergency rooms unless absolutely necessary, and the cost of health care overall is also growing.
“When it comes to cost, health insurance and health care is one of the fastest rising expenses,” Haar said. She explained the different health care options available. The first place to seek help to seek help is often is the primary health care physician. Haar said that primary health care physicians are harder to find because health care is now required. The primary health physician knows an individual’s medical history. They can take care of minor illnesses and recommend seeking other medical help when necessary. “They are really the person who is coordinating your care,” Haar said.
Urgent care facilities were the second places Haar said a person could go to for health care. These facilities are found online or through yellow page searches. Urgent care facility workers can write prescriptions and administer care for things like broken bones or the flu. “There are absolutely times you should be using the emergency room,” Haar said. In the case of heart attacks, strokes, shortness of breath or passing out, the emergency room is the best place to go.
Cassel said that depending on the condition, an urgent care facility may recommend an individual to go to the emergency room. She used the example of her daughter having asthma. When her daughter has an asthma attack, even though Cassel knows that her daughter needs her respiration to be treated, if she took her to an urgent care facility, her daughter would be recommended to the emergency room. Cassel said that usually an individual can call a health care official to know whether the emergency room or urgent care facilities are necessary. “Sometimes it does take a phone call,” Cassel said.
Cassel also discussed where to go to get inoculated. “When it comes to flu shots and shingles vaccines, they will not be covered in full in a health care clinic,” Cassel said. Frequently people go to their primary health physician; however, Cassel said that it will be more expensive. Instead, people can go to places that offer health care services, such as CVS or Wal-Mart. These places often have stations specifically for administering health care.
Haar explained the differences between Capital Blue Cross and ConnectCare3, which can both be available on certain health insurance plans. Capital Blue Cross primarily gives information about where emergency rooms and health clinics are in the area. ConnectCare3 is available to everyone on the College’s health care plan and consists mostly of nurses who can provide information on conditions and help the individual know what questions to ask their doctor. Additionally, an individual will always have to contact ConnectCare3 in order to get information, whereas Capital Blue Cross has begun reaching out to people to see if they want to participate in programs like diabetes treatment or maternity management. Cassel also said that ConnectCare3 tends to have more national-level research and Capital Blue Cross has more information about a customer’s medical history.
Haar also delved into brand name drugs versus generic drugs for prescriptions. “In most cases there’s no reason not to use a generic drug,” Haar said. The main difference is that generic drugs use different colors and fillers. She said the only reason to use the brand name drugs is if the individual is allergic to the generic. If the patient is allergic to the generic drugs, health care plans will often pay the difference in cost. The generic drugs only become available if the patent for the brand name version has expired. In the case of the patent still being in place, the individual may be able to get a substitute that mimics the effects of the original.
Haar said that the best way to avoid needing these health care measures is to make smart decisions in terms of diet and exercise. Getting blood pressure, cholesterol levels and heart rate checked regularly can also help the individual monitor their health. She also advised getting checked early and getting the best procedure done in the case of health issues. “When it comes down to procedures, it’s not always about getting the best cost. It’s about getting the best care,” Haar said.