Category Archive

2022 February

Is An HMO Right For You?

Picking an insurance plan from year to year can feel like sorting through a full alphabet soup of acronyms. After a while, it can be hard to tell the difference between your HDHPs and your PPOs.

A plan that’s been out of the spotlight for some time is the HMO, which stands for Health Maintenance Organization. Like any health plan, it has its advantages and disadvantages. Knowing those can help you make a more informed decision regarding whether an HMO is the best plan for you and your family.

HMOs operate on a network system, which means an HMO gives you access to a group of providers (doctors, hospitals, etc.) that has agreed on certain pricing for members. This is one of the HMO’s greatest advantages: it is generally an inexpensive plan with low monthly premiums and out-of-pocket costs that focuses on preventive health, like annual checkups.

However, most HMOs will only cover visits to in-network providers, with the exception of emergency care. This means that if you already have a primary care physician (PCP) or other doctor who is not in the network, your visits will not be covered at all and you will be responsible for the entire cost. Similarly, many HMOs require you to select an in-network PCP to coordinate all your other care through. For instance, if you need see a specialist, your PCP will likely have to provide you with a referral to another in-network provider. There are also often other restrictions on coverage – the plan may only cover a certain number of visits or tests.

While HMOs are generally inexpensive plans, they contain many restrictions on care. If you are healthy, only see the doctor once or twice a year, and don’t foresee any major health complications, this may be a good choice for you. If you have any chronic health conditions, need specialist care, or see a doctor regularly, you may be better off choosing a plan that offers more flexibility.

RESOURCES:

Health Maintenance Organization (HMO) – HealthCare.gov Glossary | HealthCare.gov
Health Maintenance Organization (HMO) « Welcome to the Home of CT Health Channel
PPO vs. HMO Insurance: What’s the Difference? | Medical Mutual (medmutual.com)

Anxiety vs. Depression

While it is not uncommon to hear people use the terms “anxiety” and “depression” interchangeably, these are actually two different conditions.

The two have overlapping symptoms and the unfortunate reality is they are often comorbid, meaning they often show up together. The National Alliance on Mental Illness estimates that 60% of people who have an anxiety disorder will also experience depression. Another study reported that nearly half of people with major depressive disorder also had histories of one or more anxiety disorders.

This side-by-side comparison may help illuminate some of the differences between anxiety and depression.

Depression

  • Ongoing sadness or hopelessness — more than just “the blues”
  • Reduced or increased appetite
  • Irregular sleep, either too much or too little
  • Seemingly constant lack of energy
  • Recurring suicidal thoughts or attempts
  • Mental fog, including difficulty thinking or concentrating

Anxiety

  • Worrying excessively or feeling anxious out of proportion to actual events
  • Inability to stop worrying
  • Feeling constantly jittery or on edge
  • Feeling overwhelmed by making choices
  • Trouble concentrating
  • Fatigue and difficulty sleeping
  • Nervousness
  • Irritability

Between different kinds of therapy and medication, there are many ways to treat anxiety and depression. If you have been experiencing some of these symptoms for more than two weeks, and they have caused a change in your level of functioning or are interfering with your life, you should speak to your doctor. If at any time you experience suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-8255 or visit suicidepreventionlifeline.org to chat with someone who can help you immediately.

RESOURCES:

What Is Depression? (psychiatry.org)
Depression (major depressive disorder) – Symptoms and causes – Mayo Clinic
The Critical Relationship Between Anxiety and Depression | American Journal of Psychiatry (psychiatryonline.org)
The Comorbidity of Anxiety and Depression | NAMI: National Alliance on Mental Illness

Snap, Crackle, And Pop

If you’ve never been to a chiropractor, it may seem like a bit of a mystery what they actually do. Chiropractors are trained specialists who use their hands or sometimes small instruments to manipulate the spine and other joints through quick, controlled movements that lead to the characteristic popping sound.

What are the benefits? Chiropractic care may effectively relieve neck or low back pain by improving the motion of one’s spine. A recent study reported that a large group of people who received chiropractic care reported less pain, better mobility, and a reduced need for pain medication. However, not enough studies have been done to prove that chiropractic adjustment is necessarily more effective than other treatments like rest, stretching, and pain relievers. Adjustment is also not for everyone. People with severe osteoporosis, spinal cancer, or numbness in any limbs should avoid chiropractic treatment.

It is best to consult with your doctor to see if they think chiropractic care is right for you, taking into consideration your personal health and medical history. If you and your doctor agree that this is the right choice, the good news is that most insurance policies cover chiropractic care, though the amount covered varies greatly between plans. Check with your insurer to find out what your coverage is and ask the chiropractor’s office how much an appointment would cost without insurance. Depending on your benefits, it may be cheaper to avoid using insurance and pay cash to the practitioner directly. If you take this route, however, that cash payment will not count toward your deductible.

RESOURCES:

Should you see a chiropractor for low back pain? – Harvard Health
Chiropractic adjustment – Mayo Clinic
Effect of Usual Medical Care Plus Chiropractic Care vs Usual Medical Care Alone on Pain and Disability Among US Service Members With Low Back Pain: A Comparative Effectiveness Clinical Trial | Complementary and Alternative Medicine | JAMA Network Open | JAMA Network

Cancer Check-Up

Getting screened regularly for cancer can bring you peace of mind and quite possibly mean the difference between life and death. Here is a helpful cheat sheet on what kinds of cancers you should be screened for and how often.

Breast cancer. This is probably the most-known cancer and screening. Guidelines vary slightly, but it is generally recommended that people with breasts 45 and older get mammograms every one to two years. For people with increased risk factors such as family history or certain genetic markers, an additional MRI screening is an option.

Cervical cancer. People with a cervix between ages 25 and 65 should get a Pap test done every three years, as it can find abnormal cells in the cervix that might become cancerous. They should also have a primary HPV test done every five years to detect the presence of HPV, which can cause abnormalities that lead to cancer.

Colonoscopy. It is recommended that people between ages 45 and 75 be screened regularly for colorectal cancer, and that anyone older only do so on the advisement of their doctor. People who have a personal or family history of colorectal cancer or certain types of polyps may need to be screened earlier, more often, or with specific sorts of tests, along with people who have ulcerative colitis or Crohn’s disease, or have undergone radiation treatment to their abdominal or pelvic area.

Lung cancer. This screening is recommended for people who smoke now or have quit within the last fifteen years, are between 50-80 years old, and have smoked on average a pack of cigarettes every day for a 20-year period. This test involves low-level uses of radiation and should only be performed on people at significantly elevated risk.

Prostate cancer. Both the Centers for Disease Control and Prevention and United Preventive Services Task Force recommend that those with a penis talk to their doctor about a prostate cancer screening between ages 55 and 69.

While screenings are not guaranteed to spot cancer, they increase your odds of catching any developing cancer at more treatable stages. Guidelines vary slightly depending on the recommending agency – talk to your doctor about what screenings and frequencies are best for you.

RESOURCES:

Recommendation: Prostate Cancer: Screening | United States Preventive Services Taskforce
Cancer Screening Guidelines | Detecting Cancer Early
Cancer Screening Tests | CDC
Breast Cancer Screening Recommendations | Susan G. Komen®