Finding Your Way in the Health Care System

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Finding Your Way in the Health Care System

From the flu to broken bones, illnesses and medical emergencies seem to be inevitable parts of raising kids. It can be stressful any time your child needs medical attention, but even more so when you're worried about where to get that care and how much it will cost.

About Consumer-Directed Health Care

We have more options for getting health care and paying for it than ever before. There is a movement toward consumer-directed health care, which is health insurance that's designed to get those who use health care — like parents — to play a bigger part in keeping costs in check.

Many different types of consumer-directed health care plans are available, each with its own benefits and limitations. Many of these plans feature high deductibles (the amount of money parents must spend before health care is covered by insurance) as well as health care savings accounts, which make it easier for parents to save money to pay for the services that insurance doesn't cover.

Some plans cover preventive care, routine checkups, vaccines, tests, and regular disease screenings, but others don't. So when you're choosing health insurance, it's important to look for a plan that meets your family's needs.

Navigating the Health Care System

Rising costs and increased variety among health care plans can make it challenging to find your way in the health care system. The good news is that making decisions while everyone is healthy can help reduce the stress and financial strain when someone in your family does need medical care.

  • Choose your coverage carefully. Carefully consider your family's health care needs. While it's impossible to predict sudden illnesses and accidents, you can anticipate some things. For example, if your child has a chronic disease (like diabetes, asthma, and allergies) that requires frequent checkups and tests, make sure to pick a plan that covers them. A representative from the insurer — or your employer — should be able to answer any questions about those kinds of issues.
  • Make a medical home. Try to establish a long-term relationship with a pediatrician or family doctor who can:
    • get to know your family
    • provide well care and most of the sick care your kids might need
    • keep complete medical records of things like immunizations and growth
    • become familiar with your family's medical history
    A doctor who has all this information, and gets to know your family over time, can better determine when your child is healthy and developing well and when something is off track.
  • Don't skip checkups. It's important to keep regular checkups even when kids aren't sick — this way, doctors can make sure they're developing as expected and can catch any health concerns early so that they don't become expensive and hard-to-treat medical problems later.

    Letting regular checkups lapse may save time and money in the short-term, but ultimately might translate into bigger bills and longer waits at the doctor's office. If parents wait until kids are really sick to see the doctor, they're likely to require more intensive — and expensive — medical care. And if hospitals and doctors have to provide a larger amount of more expensive care, they’ll ultimately have to charge consumers more to cover their costs.
  • Keep vaccines up to date. Checkups are especially important so that kids can stay current on their immunizations. In recent years, vaccines have been developed to stem illnesses like the flu, infantile diarrhea (rotavirus), hepatitis, meningitis, and human papillomavirus (HPV). Parents have more opportunities than ever to keep kids healthy and safe from contagious illnesses.
  • Don't delay care. When kids are sick or injured, it can be difficult to decide how much medical care they need. Ultimately, if you're unsure about what medical care your child needs, your doctor — or a nurse who works in the office — can help you determine what to do. The important thing is to ask questions before something turns into an emergency.
  • Check it out before you act on it. More health and medical information is available than ever before — on the Internet, through support groups, in magazines and newspapers. All that information can be helpful, but you should never rely on it as a substitute for medical care or advice given directly to you by a medical professional. It's important to check out anything you hear or read that might be relevant to your child's health with a doctor or nurse before you act on it. He or she can tell you whether that information is accurate and appropriate, given your child's health and medical history.

Reviewed by: Steven Dowshen, MD
Date reviewed: September 2013

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Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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