Tips self-care for family - Home health care

Tips self-care for family - Home health care

Home health care

How to Advocate for Yourself in the Healthcare Benefits System

Parents Reaching Out provides resources that focus on helping families make informed decisions about the care and education of their children. Keeping your family healthy means knowing how to navigate the health care system and talk with your doctor or other providers. We hope these tip sheets will give you the information you may need to access the best, most cost-effective medical and related services to meet the needs of your family.

Here’s what you’ll need to do to prepare yourself to advocate:

• Know the facts. Review any paperwork that you have received or submitted. Make noteof key dates and as many of the important details as possible. Knowing your case well can put you way ahead of everyone else. If you are appealing your health plan’s denial of a service, read the denial carefully to see why they are denying it. Use their reason as the basis for your argument to say why you should get the service.

• Keep good records. When you make a call about your insurance issue, take note of whom you talked to, the date and time, and what the conversation was about. Keep copies of all correspondence, both what you send and what you receive.

• Do your research. If your health plan is denying you a service or medication, search the Internet for information about the service and why it is medically necessary or appropriate for your condition. Print out what you find and include it as part of your grievance or appeal.

• Practice what you want to say in advance. Tell your story to a friend or family member and ask for feedback.

• Figure out your bottom line. If there might be a compromise position, decided in advance how much you are will to compromise or whether you are willing to compromise at all.

When you advocate your position:

• Tell your story. You lived it, so you know it best. Be organized and communicate the facts in a logical way.

• Stick to the important points. Figure out what is most important for the other person to hear and relay the information as concisely as possible.

• Concede the negative points. If there are negative things about your case, explain what occurred. You can take the impact out of the bad points and make them less negative.

• Be respectful. But firm. You will lose points in your case by being disrespectful of the other side. If the people opposed to you are disrespectful, the decision maker will notice this, but you keep your cool. Keep your focus on the story that you are telling. Have your evidence with you. Bring all relevant documents with you when you go to advocate your case. Make copies for the other side and for the decision maker ahead of time.