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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!

Make these preventative healthcare appointments this month for an easier 2023

Make these preventative healthcare appointments this month for an easier 2023

As a child, our parents are responsible for making sure we get our regular check ups and vaccinations, but as an adult- throw in figuring out health insurance- things get so much more complicated! 

Scheduling doctor appointments is a necessary task that can come with a lot of headache and uncertainty. How often should we go? Where do you find a primary care physician???? 

Just like you get your car a check up before you go on a long trip, it’s important to regularly check in with appropriate medical professionals in order to prevent a bigger health crisis down the road. Which screenings do we need throughout our life and at what intervals? Let us help you relieve some of that stress by following these scheduling and screening tips! 

Read on for a list of appointments you should make this year, and remember to ask if your insurance is in-network when you schedule! We’ve got a handy tool at the end of this article to help you keep track of your appointments. 

Appointments for All Adults 18+

Primary care physician (PCP)

When: Annually 

Who: Everyone. Seeing a PCP on a regular basis is the best way to monitor your wellness. Your PCP will be able to help you make an informed decision on what appointments you should add to your annual list.

Dentist

When: Every 6 months

Who: Everyone

Gynecologist 

When: Annually or if pregnant/trying to conceive

Who: People with female reproductive systems. It is recommended that you begin annual gynecologist visits as a teenager or after you become sexually active. Regardless of sexual activity, it is recommended that your first visit be by age 21 at the latest. If you have a new sexual partner, an STI test is recommended. If you regularly have more than one sexual partner, it might be wise to have a STI and Pap test every 6 months.  

Eye doctor

When: If you have healthy vision, schedule a visit once in your 20s, twice in your 30s, and once at age 40. Those with existing vision needs should follow their eye doctor’s recommendations on frequency of visits. If you develop any vision difficulty or eye problems, a check up is recommended.

Who: Everyone

Dermatologist

When: Annually

Who: Everyone, especially if you spend a lot of time in the sun, are fair-skinned, or have family history of skin cancer.  

Vaccinations

When: As recommended. Your PCP should be able to help you decide when to get vaccinations or boosters. Vaccine recommendations frequently include: 

  • Annual flu vaccine comes out around September
  • HPV vaccine and meningitis for young adults 
  • Shingles
  • Covid 19 vaccine and appropriate boosters

Who: Everyone

It’s important to get regular appointments with your doctors so they will have a baseline for your health conditions in case things change.

Appointments for Adults ages 40 +

Gynecologist – Mammogram

When: Annually 

Who: People with breasts

PCP – Rectal Exam/PSA blood test

When: Annually

Who: People with prostates 

Gastroenterologist – Colonoscopy

When: Regular screenings are recommended for those between the ages of 45 and 75. If your colonoscopy shows no signs of cancer, you can typically wait 10 years before scheduling another one. 

Who: Everyone

If you’re 50+, add this l screening to your list:

Lung Screening

When: Annually

Who: Adults who have smoked 1 pack of cigarettes per day for 20 years or 2 packs per day for 10 years and currently smoke, or adults who have quit smoking within the last 15 years.

If you’re 60+, add this screening to your list:

Osteoporosis Screening

When: Age 65 and up

Who: Cisgender women and People assigned female at birth

If you have a family history or risk factors of any particular diseases, talk with your PCP to decide if you need earlier, more regular, or other specific screenings. Remember, prevention is better (and cheaper) than the cure!   

Extra tips:

  • Need a New Year’s Resolution? Schedule all of your doctor appointments before the end of January so that you can cross that task off your to-do list and feel good about prioritizing your wellness
  • The ACA covers 100% of preventative health care. Visit Healthcare.gov for more information.
  • Add travel time to your appointments in your calendar
  • Remember to wear short sleeves to doctors appointments so they can easily take your blood pressure

We know keeping up with all of these appointments and screenings can be overwhelming. If you’re a visual organizer like us, please use our fillable guide to make sure all of your appointments are scheduled. Hang the guide on your fridge or in your office so that you’ll never miss an appointment! 

Cheers to taking care of ourselves and advocating for our health in 2023!  

What Is A Death Doula?

Guest Author Ellen Abbott

As we approach Halloween and Día de los Muertos, it seemed appropriate to get a little more matter-of-fact about deathcare resources. One end-of-life resource that we want to highlight is the option of engaging a “death doula” for those who are facing the end of their lives. 

Our guest blogger this week is Ellen Abbott. We met Ellen in her role as Care Manager for Visionary Care Consultants but soon learned that we shared an interest in helping people through some of the most difficult transitions of life.  Ellen completed her certification as a death doula in 2019, so we asked her to tell us more about what a death doula is and how they serve those at the end of their lives. 

Contact Ellen at ellen.abbott615@gmail.com or check out her website if you’d like to learn more about death doulas.

The W’s of Death Doulas

You may have heard recently about a “death doula” or an “end of life doula” and wondered who they are and what do they do? As a death doula myself, I’m happy to tell you! 

What is a death doula?. We use midwives to educate and assist families to help bring babies into the world, why not have the same for those who are towards the end of their journey here? 

There is a growing movement among end-of-life professionals in the United States to bring back the role of a non-medical person who stands in the gap between doctors, hospice, and the family of a dying loved one. This person guides the family and the client around the maze of the healthcare system, educates on hospice, offers practical information about death and provides emotional support around the entire process. 

Who do death doulas serve?

A death doula serves the dying person as well as their loved ones. The goal of a death doula is to make sure that their client’s final wishes and needs are carried out before, during and after their death. This creates a healing and easier transition for the client and family. 

When should a death doula be called?

You don’t have to have a terminal diagnosis to hire a death doula. There are some doulas who focus on helping their clients plan so that they know what they want at the end of life, and instructions on what the family needs to know to carry out those wishes. This is extremely helpful to the family and client since the topic of death and final wishes are not popular conversations in today’s world. 

How do death doulas charge for their services?

Every death doula is different. Most offer free consultations and then an hourly rate of anywhere from $30-$100 an hour. Some offer packages for legacy planning along with being present for the client at the time of death. In middle Tennessee there is a Death Doula alliance, made up of local doulas that have been trained specifically for this role. They come from all backgrounds but usually from nursing, social work, counseling or clergy. 

Over the last century, death has been viewed as a medical failure even though we all know one day we will die. A death doula helps to normalize these conversations and talk about these topics that no one wants to bring up. The death doula starts with the end in mind, to ease client’s fears, knowing they have a plan and someone at their side when the time comes.

How can I plan long-term care with TennCare?

TennCare is Medicaid

What is TennCare? (A brief overview of Medicaid)

Quite simply, TennCare is Tennessee’s Medicaid program. While the name “TennCare” has the word “care” in it, it is NOT Medicare. In order to further clarify the difference between the terms “Medicaid” and “Medicare,” you need to remember that we use “Medicare” to “care” for our elders and “Medicaid” to “aid” those, of any age, in need. Essentially TennCare is Tennessee’s brand of Medicaid. Hopefully, that little trick will help you remember the differences between each program. 

Who qualifies for TennCare?

Now that you are familiar with the difference between Medicare and Medicaid, let’s discuss who qualifies for TennCare (Medicaid). 

There are three qualification criteria that you must meet in order to obtain Medicaid/TennCare. 

1. Medical qualification There is a special medical test that applicants must pass in order to qualify.  Usually, a care facility will handle this piece of the Medicaid application. 

2. Asset qualification – A TennCare applicant who is single can only have $2,000.00 in assets before they are eligible for TennCare.  Vehicles and real estate are usually exempt from the count of assets. A “Care and Savings Assessment” is a good place to start if the applicant needs help with figuring out what they have in assets and what options are available to make excess assets “non-countable” for TennCare purposes. 

3. Income qualification – A TennCare applicant can only receive $2,382.00 per month (as of 2021) in order to receive TennCare. If an applicant has more than this amount in income, an attorney can resolve it through what is called a Miller Trust or a Qualified Income Trust.

Long-term care is very expensive

Why should I be concerned about long-term care services?

Unless you are a millionaire or multi-millionaire, TennCare eligibility and designation could have a major impact on your finances and your family. While you may not need TennCare now, you will want to plan as if you will need it in the future. As you may have heard us say before “we hope for the best, and plan for the worst.” Having a plan is an effective way to ensure that you will have long-term care coverage when you need it. This isn’t to say that you won’t find yourself needing TennCare much sooner than expected. When this happens we call it “TennCare Crisis Planning”. 

Knowing your options makes all the difference

I don’t know where to start!

The biggest obstacle to TennCare planning is determining what to do with your assets and income; especially if there is excess in any category. There are a lot of rules and potential pitfalls that you need to look out for. Fortunately, we have some great financial planning and legal resources that can help our clients. If you have an immediate need for TennCare or want to plan for TennCare we can supply the client with what we call a “Care and Savings Assessment”. It’s a wonderful tool that helps people effectively navigate through their options.

How do we help our estate planning clients with TennCare planning?

For our estate planning clients, we like to take into consideration the possibility that you may need TennCare in the future. 

For example, it is our priority to set up our client estate plans to make sure that TennCare is accessible if it is ever needed.  As with many government organizations, Medicaid has lots of rules to follow and many people find that they did not know what rules they were supposed to be following until it was too late!   Fortunately for our clients, we know the rules and can help you plan in advance of ever needing to apply for TennCare to cover medical care.  Additionally, we create documents that make sure that someone can apply for Tenncare on your behalf. This is useful if you become incapacitated in the future. 

How do we help our Conservatorship clients with TennCare? 

Many of our conservatorship clients are caregivers for a loved one who requires skilled nursing to keep them safe. The average cost for this type of care is about $7,000.00 per month or more.  There is usually a large gap between monthly income and fees.  Our firm can navigate the TennCare application process and assure that the appropriate language is in the conservatorship order paperwork with the court so that the client may obtain the appropriate benefits for their loved one.  

How do we help clients with TennCare Crisis planning? 

For those who have never considered the cost of long-term care until they or a loved one need to enter a nursing facility, the cost of care is likely to come as a shock- and an unaffordable, but necessary, expense.  This is when we can step in with what we call “crisis planning,” meaning that you need a plan and you need a plan now

In these cases, we are able to look at the household financial situation of the person needing skilled care, as well as the family situation overall, and come up with a plan for how to best use existing resources and get them qualified for TennCare benefits to pay for the nursing home bills. This process called our “Care and Savings Assessment”,  is one of the most rewarding things that we do!  It allows us to help people get the care that they need while still providing a quality of life for themselves and their families. 

If you are concerned about accessing TennCare benefits for long-term care, contact our office for a complimentary initial call using our online calendar here

Read our article about Medicare planning.

Have you thought about qualifying for TennCare in the future?

You’re almost 65. Congrats on your Medicare Milestone!

We’ve been talking about Medicare for a few weeks now, but we haven’t gotten to the how-tos yet.  That’s about to change. Today we dig into how you actually enroll in Medicare. 

Your first Medicare enrollment period begins three months before you turn 65 and runs until three months after.  Even if you don’t sign up for any other coverage, we recommend that you sign up for Medicare Part A during this first enrollment period. 

To sign up for Part A, go to the Social Security Administration’s Medicare portal here.  It will be helpful to set up an account for when you come back to sign up for Part B or when you are ready to begin receiving retirement benefits. 

If you are signing up for Parts A and B, the process is the same. You’ll sign up through the Social Security Administration’s website. Remember that if you enroll for Part B, your premiums will either be deducted from your Social Security retirement payment or you will receive a bill. The 2021 Part B premium is $148.50 for most people.

If you are looking for a Medicare Advantage plan, Part D, or a Supplement (Medigap) plan, you will want to compare plan options using a plan comparison service.  There are insurance brokers like Kendall Chanley and Harry Perret here in town who can help you compare options and narrow things down. Once done, they will get you signed up. These services are free to you and it’s nice to have one agent who can help you each year. 

If you prefer to do things yourself or just want to do some exploring, Medicare.gov will allow you to find plans in your area and narrow them down based on what you are looking for and price ranges. I recommend filtering plans by the star ratings (four or above) and then whether you are looking for dental, vision, and prescription medicine access. 

Once you make it through your first enrollment period at age 65 (ideally), you’ll be eligible for open enrollment each year from October 15th through December 7th.  You may also have options to select coverage during a special enrollment period if you lose other coverage. 

Applying for Medicare isn’t nearly as scary as it sounds, but it does require advanced planning and research. You don’t want any deadlines sneaking up on you! Personally, I love using reminders on my calendar well in advance of any deadlines that I have. Maybe one to begin research, one to call an expert, one to compare plans, one to sign up….all before your birthday or November. 

What’s your plan for Medicare enrollment?  Head to our Facebook page to share your plans in the comments!