Northeast Wisconsin
  • Northeast Wisconsin
  • June 2017
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Take charge of your health

Higher health care and insurance costs require us to take charge of our health. The good news is that new programs are emerging to control cost and improve health.

A few years ago a client called about coverage for monthly cholesterol screenings. His doctor wanted to put him on a statin drug for high cholesterol, but he wanted to try diet and exercise first to avoid the cost of medicine and potential side effects.

His health insurance plan would only cover cholesterol tests if his doctor recommended it as being “medically necessary,” and since his doctor already recommended a medicine, it would not be covered.

He told me his last cholesterol test covered by insurance was billed at $212, but reduced to $80 after applying the insurance discount.

Someone who wants access to a cholesterol test at a set price any time without a doctor or insurance company approval can travel to Manitowoc. Holy Family Memorial (HFM) has three clinics there that offer direct lab tests. It’s like going to McDonalds. You check off what tests you want from a menu of 73 items, pay up front, sign a release form and have your blood drawn. That’s it. The test results are mailed directly to you within a week.

The HFM direct lab test for cholesterol costs $20. It is listed as a lipid panel that includes total cholesterol, HDL, LDL and triglycerides.

To learn more about the HFM program, www.hfmhealth.org and click on “Services,” then “Lab Services” and finally, “Direct Lab Testing.”

The direct lab program is an example of how people are changing health care to be more patient-centered — it offers access, set pricing and convenience.

Faced with higher deductible plans, providers are realizing that more payments come directly from the consumer and not insurance. As a result, health care providers are rethinking their services to meet consumer wants and needs. The big shift is a focus on health. More consumers are asking for help to avoid the need for expensive medical care because they do not want to pay their higher deductible.

Finding new ways to engage health consumers to achieve better health is one of the big challenges for providers. Whether it is a diet and exercise approach before medicine or access to tests to measure health progress from a lifestyle approach, more people want help to improve health and lower cost.

Remember to always use a licensed health insurance advisor to learn more about your health insurance options for health care. 

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