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April Harris Jackson

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Finding the right doctor for you and your needs

Right doctors for your primary care needs

So you’ve been to your primary care provider and they’ve told you it’s time to see a specialist. Or maybe they’re changing practices or retiring! Or maybe you’re looking at our list of recommended doctors appointments and realizing you need to make some new appointments as you get older. Whatever the case, now you’re tasked with finding a new doctor – and it might feel daunting.  We’ve got some tried and true recommendations to make this task just a little easier for you. 

Don’t be afraid to ask for a recommendation!  

Start with the doctor you trust – who do they recommend you visit? Maybe that’s a specialist within a greater healthcare system (Vanderbilt, St. Thomas, etc.) or maybe it’s someone who has expertise in your specific diagnosis. But don’t stop there! Next, if you’re comfortable, reach out to your family and friends to see if they have a provider whom they really like. Why do they like their doctor? If you trust their opinions, this might be a good resource for you. 

If you’re able, consider the possibility of driving to get a good doctor. Sure, they’re on the other side of town, but if they come highly recommended and you’re only going 1-2 times a year, it might be worth the traffic! 

Lastly, be sure to consider any deal breakers. This looks different for everyone, but it could include transportation factors, a specific focus in their practice, or you’re looking for a doctor of a specific gender (like a female OB/GYN). Take my example – my husband and I are child-free, so I was very pleased to find a gynecologist who doesn’t also help with childbirth. It means she is able to focus on what matters to me and isn’t away delivering a baby when my appointment time comes around. 

Check out their internet presence. 

Most offices these days have a website, listing their hours, providers, and even patient ratings of the physicians.  Do you like what you read there? Or is there something that makes you think twice? If there are comments, take the time to read those, as they may give you a deeper understanding of the provider’s demeanor and care (rather than just a 5 star rating). 

Additionally, use this website to confirm the doctor’s licensure. You can also view any disciplinary matters on your particular doctor in their Practitioner Profile on this website. 

Contact the provider’s office.

The last thing you want is to show up and find they only accept a certain type of insurance coverage! Call the office and ask if they take your insurance; you can find your information on your insurance card. Keep in mind that the staff may need to look up the information, but “I don’t know” is not an acceptable answer here. If the person who answers isn’t sure, ask to speak to someone in the billing department to verify your coverage. 

Don’t forget to also ask if you will need a referral to their office from your primary care provider. Some specialists will accept self-referrals, but your insurance company might think otherwise! 

What about a copay? 

Oftentimes, your insurance card will list a copay amount for various types of providers. If not, be sure to log in to your insurance company’s website and verify the copay, or call the number on your card to speak with a representative. Specialist visits typically have a higher copay amount than a regular PCP appointment; you will want to be prepared. 

Remember: just because you see a doctor once doesn’t mean you have to continue seeing them.  Just like any professional, you should find someone that you are comfortable with – which isn’t a reflection on the doctor or their skills, sometimes it’s something that you just have a gut feeling about and want to find a better fit.  Feel free to tell the doctor this. If you can articulate what you want, tell them and ask if they have a recommendation. They probably know other doctors in their area! 

You and your provider are a team, and by working together, you should be able to ensure you are taken care of for years to come! You have the ability to direct your healthcare and make decisions for your future; hooray for being proactive! 

How do I qualify for Medicaid?

Long-term care is expensive

Many people have sufficient income to maintain a regular lifestyle but are unable to afford the high cost of long-term care. With the average cost of long-term care around $7,000.00 a month, it is incredibly difficult for most families to afford it, even more so after retirement. That’s why it’s a good idea to plan for qualifying for TennCare, also known as Medicaid.

Evaluate and restructure your assets to qualify for TennCare

do you know how to qualify for tenncare? Image is of a man in a long-term care facility. He is taking a walk with a nurse and his partner.
It’s worthwhile to know how to qualify for TennCare

As we discussed in our blog last week, there are certain criteria you need to meet to be eligible for TennCare. As an elder law attorney, one of my jobs is to help families get their loved ones qualified for TennCare while maintaining resources available for the rest of the household.

One of the ways that we do this is by restructuring a family’s assets. We do this by turning resources that are countable for TennCare purposes into items that TennCare does not count as part of its eligibility assessment

This process is known in the elder law community as a spend-down. The goal of the spend-down is to make you or your loved one eligible for TennCare as far as your assets are concerned. If you are overqualified for income-based criteria, we can use a special type of trust called a Qualified Income Trust, or a Miller Trust, to reduce your income. The goal of a spend-down is to maintain the quality of life for all family members including those who need long-term care. 

Image of a scooter as a mobility device. Buying a scooter is a good way to spend down your assets to qualify for tenncare
Bob might benefit from purchasing a quality mobility device

What is a “spend-down”?

For example…

Bob needs to go into long-term care. Bob is eligible based on his income. He makes $2,000.00 a month of social security retirement income. Bob also has a house, a car, and $50,000.00 in the bank. Bob is widowed and his children are adults. 

We need to do something with at least $48,000.00 from Bob’s bank account in order to make him eligible for TennCare. His house and his car are not countable for TennCare purposes in most cases. What can we do? 

  • Make improvements to his home that would improve his quality of life and access to the things that he needed in the home. This might include: 
    • Grab bars in the shower or hallway.
    • A ramp into the main entrances.
    • Paving the driveway or expanding it closer to the door 
    • Widening doors 
  • Buy some things for Bob that his Medicare did not cover, such as:
    • Hearing aids
    • Dentures
    • Eyeglasses
    • Top of the line mobility devices 

There may be other things that would improve Bob’s quality of life. There are things we can spend money on or convert into income. I am also going to suggest to everyone that they use the money to make arrangements for end-of-life needs if they have not done so already. Since at some point Bob’s children will need to make arrangements for his burial or cremation, paying for it now from his excess funds is a great way to make those funds unavailable for TennCare purposes and meet a future need. 

image of a smiling older gentleman sitting with his daughter. Do you know how to qualify for medicaid?
Bob has peace of mind because he has plans in place for long-term care

Bob might want a Care and Savings Assessment

It’s not easy getting approved for TennCare / Medicaid, and we know it! That’s why we offer help in planning your steps to qualify. It doesn’t matter what your starting point is, we’re here to help you navigate the process with one goal: get our clients the quality of care that they need. Contact us if you would like to make plans for qualifying for TennCare.