Understanding Hip Dysplasia

Tracking and Financing Healthcare

The best way to track of your healthcare, or your child’s healthcare, is to keep your own, personal, set of notes and records. Just a small diary of appointments and treatment events will help remember important events. Your records can also help the doctor(s) treating you/your child, especially if you change doctors or need a second opinion:

• You don’t need to record every detail, but some notes about recommendations and treatment plans are helpful as a reminder for you and for your doctor.
• A list of medications, allergies, immunizations, and dates of surgeries or illnesses is useful.
• If you or your child has other conditions (diabetes, asthma, etc.) your notes will help you transmit information from one doctor to another and keep track of all the things you need to do for each condition.
• It’s also helpful to keep phone numbers and addresses of all doctors, orthotists, hospitals, and others who may help care for your child.
• Use your digital phone to take photos of one or two x-rays when they are on the monitor in the doctor’s office. Keep these with the records in case you need them years from now.
• If you are planning to move or change doctors for any reason, it’s a good idea to ask for copies of your records, x-rays, and laboratory studies to keep at home. It’s easier to collect these records as treatment occurs rather than gather it all later.
• If you notice errors or inconsistencies in any records, please tell your doctor. Good doctors will appreciate your help because they want to make sure their records are accurate and complete.

Healthcare Insurance and Financial Assistance

Knowing your choices will help you be a better advocate for yourself or your family. Financial issues vary from country to country, but are always an important part of medical care. Local governments and hospitals employ social service workers who can help you find financial assistance if you do not qualify for traditional private or public healthcare funding.

U.S.A. Insurance and Financial Assistance

For more in depth answers to your questions, the IHDI recommends this Medical Billing and Coding website: https://www.medicalbillingandcoding.org/health-insurance-guide/overview/.

Specific information is available for the following topics:

• Overview of Health Insurance
• Affordable Care Act
• Medicaid
• Health Insurance for College Students
• Navigating Healthcare for the Uninsured
• Understanding Medical Bills
• Commercial Health Insurance

Centers for Medicare and Medicaid Services also provides comprehensive information about regulations including private insurance and government services. https://www.healthcare.gov/ This includes regulations for Pre-Existing Conditions:
“The Affordable Care Act created the Pre-Existing Condition Insurance Plan (PCIP) to make health insurance available to those that have been denied coverage by private insurance companies because of a pre-existing condition…. everyone will have access to affordable health insurance choices through Health Insurance Marketplaces.” No insurance plan can reject you or charge more because of a condition you had before your coverage started.

What are the types of insurance?

Insurance organizations, also called managed care organizations (MCOs) and health maintenance organizations (HMOs) may require you to see a primary care physician first, who will determine whether to refer your child to a pediatric orthopedist. In most cases, the managed care organization will not pay for a visit to a pediatric orthopedist unless you get a referral.

If you see a pediatric orthopedist without a referral, you may have to pay for all or most of the cost of the visit out-of-pocket and find yourself with no insurance for needed tests or procedures. This is why it is important to check with your health insurance provider to see if a referral is required before a visit to an orthopedic specialist.

Preferred provider organizations (PPOs) allow you to see only the doctors who belong to the PPO network. If your pediatric orthopedic surgeon is not on the list of approved providers who are part of the PPO plan, you’ll have to pay an extra fee to see him or her.

These insurance plans are typically offered by employers, but may be purchased by individuals outside of employee benefits.

What should I know about costs?

Understanding these terms will help you determine additional cost to you:

• Premium payment – cost you pay for your insurance plan.
• Co-payment – the amount you pay for office visits or hospital services.
• Deductible – the amount you have to pay out-of-pocket before any insurance coverage is applied to services.
• Extra costs – these amounts may be applied for emergency care or visits to out-of-plan doctors.

What should I know about choosing a doctor?

Many people prefer to be treated by a doctor they know and trust. That’s important for the patient who has been seeing the same doctor for years, and for the person who hears good things about the doctor from a relative or close friend. Some important questions to ask about your plan include:

• Will I be able to see my pediatric orthopedist of choice?
• Can my pediatric orthopedist join the plan I have already?
• Does my plan have an option to allow me to see any pediatric orthopedist, even if he or she is not in the plan?

What if I’m not happy with the plan I have?

Investigate whether your plan has an appeal process. It may be time consuming, but be active on behalf of yourself and your child. If you are not able to get a quick resolution of your concerns with your plan, changing plans maybe an option. Be aware of clauses in insurance plans that address certain medical conditions that are already being treated. These “pre-existing” clauses may cause a lapse in insurance coverage for certain services needed for your child. 

What if I do not have health insurance coverage for my child?

Other options for health insurance coverage that may be available for your child include Medicaid and Child Health Insurance Programs (CHIP). These programs are federally funded and state administrated. They are based on the age of your child and income of your family. Some plans are based on the medical needs of your child. Each state has different rules about the eligibility and the services offered by these programs.

European Insurance and Financial Assistance

Healthcare financing varies from country to country in Europe. Most provide universal coverage through national health plans or through highly regulated private health insurance companies along with government subsidies for those who cannot afford to purchase their own health insurance. Each country maintains information websites for those who need assistance.

Australia and New Zealand Insurance and Financial Assistance

New Zealand has a mix of public and private healthcare delivery with information available here [https://www.newzealandnow.govt.nz/living-in-nz/healthcare/healthcare-services]

Australia has a mix of public and private healthcare delivery with information available here  [https://www.health.gov.au/about-us/the-australian-health-system]

North, Central, South American Universal Health Coverage for Citizens

The following countries provide universal health coverage by various different methods and with varying accessibility to high quality care.

• Canada
• Argentina
• Bahamas
• Brazil
• Chile
• Columbia
• Costa Rica
• Cuba
• Mexico
• Peru
• Trinidad and Tobago