Key Steps Can Make You a Strategic Health Consumer This Fall

As you experience life, health coverage changes. When you take a new job, what’s the best time to give notice so benefits don’t lapse? How can you beat the cost of COBRA?

If you accept a new position and your last day falls at the beginning of a month, insurance coverage generally lasts through that month. Keep updated on vaccines, preventative screenings and physicals to stay well and lessen medical stress.

Qualifying Life Events (QLE)

A QLE constitutes a change such as marriage, divorce, childbirth, adoption, turning 26 years old on parent coverage, geographic moves, and losing current eligibility. A QLE may be a student attending college, seasonal workers, gaining citizenship, AmeriCorp service or other events detailed at healthcare.gov.

In a QLE, you’re eligible to extend benefits through COBRA. When you work for an employer with 20 or more employees, you can obtain continuation coverage and pay the entire premium. Marketplace plans may yield comprehensive coverage at less cost. The Affordable Care Act (ACA) increased options for the uninsured.

Choosing Insurance With Mental Health in Mind

People are often surprised that choosing insurance from the exchange or marketplace is less expensive, especially with the help of a broker, who may alert to subsidies that defray costs.

Authorized insurance brokers help you choose health plans; they also aid administratively if you encounter problems. There’s no fee when you use an authorized insurance broker.

The ACA (ObamaCare) behavioral health is treated like medical care, with no appointment caps, spending limits or denials due to pre-existing conditions, including substance abuse disorders.

The challenge is finding therapists who accept your insurance because some insurers (Aetna, BCBS, Magellan, others) do not remunerate on par with cost of living and professional experience. This is why some therapists accept private pay only. Check if your current clinician accepts any plan you may move to before you sign up.

Smart Consumer Moves

By fall, many people meet annual deductibles which means appointments may be paid in full to the end of a benefit year. This would be the time to schedule therapy if there’s stress in your life.

Medicare members have an expanded network since licensed counselors, marriage and family therapists can now bill for Part B approved services, providing they're approved Medicare providers.

Be proactive with preventative screenings, eye checkups, order glasses if you have unused vision benefits, dental cleanings, and over-the-counter products if your Medicare Advantage plan or Flexible Spending Account (FSA) covers.

The FDA approved updated COVID vaccines Pfizer-BioNTech and Moderna monovalent (single) component corresponding to Omicron KP.2 strain of SARS-CoV-2 and Novavax Adjuvanted, monovalent corresponding to Omicron JN.1 strain of SARS-CoV-2.

All are effective at reducing hospitalizations and deaths. Pfizer and Moderna are mRNA vaccines that tell your body how to make the necessary protein to fight coronavirus; Novavax is a protein subunit vaccine, a direct injection of a modified protein that stimulates the immune system to make antibodies and T cells to fight the virus.

Educate youth about the many vaccines that keep them healthy.

Source: Chanikarn Thongsupa/RawPixel

If this sounds scientific, read articles and books that educate and make you feel more comfortable. On Call: A Doctor’s Journey in Public Service elucidates biotechnology for the layperson as none other than Dr. Anthony Fauci can tell it.

The Centers for Disease Control (CDC) recommends everyone five years and older be vaccinated against COVID-19, and it recommends a flu shot. The detailed CDC website helps you choose.

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Emotionally, children might fear an “ouch” and educating them through bibliotherapy makes vaccines easier. Studies have shown that bibliotherapy (storybooks) represents an underutilized tool for children in pediatric oncology settings, explaining diagnosis and treatment in a relatable way to process questions and emotions. Another study showed that while on a therapy waitlist, bibliotherapy resulted in 15% more children being anxiety-free after 12-24 weeks. While neither study discusses vaccines, one can extrapolate that reading appropriate books lessens children’s medical anxiety overall.

Little Golden Book Dr. Jonas Salk discusses how the scientist physician prevented an influenza outbreak. He began virus research in Pittsburgh, discovering protection against polio. Dr. Salk gave his vaccine to his own children and polio pioneers he recruited.

The Little Golden Dr. Fauci details various health concerns as well as his decades in public services at the National Institutes of Health. The book ends with the global pandemic and everyone able to get their vaccines.

Discounted Mental Health Services and Other Free Help

If cost is a concern, look at counseling services through universities and community clinics that train graduate students, who undertake internships or work clinical hours toward full licensure. They work under supervision of those fully licensed; two minds attending to your case.

Ask experienced clinicians if they slide fees if they don’t accept your plan. For dental, vision and other therapies, use these same approaches.

County health departments operate clinics, especially for childhood vaccines. They often disseminate free COVID tests as your library might also. The government periodically sends free kits for those who request online.

To find a therapist, visit the Psychology Today Therapy Directory.

Copyright © 2024 by Loriann Oberlin, MS