Health Care Insurance

health care safety and quality

Archive for the ‘Getting Help’


Safe Health Care in five steps


Patient safety is one of the Nation’s most pressing health care challenges. A 1999 report by the Institute of Medicine estimates that as many as 44,000 to 98,000 people die in U.S. hospitals each year as the result of lapses in patient safety.

The following steps tell you what you can do to get safer health care. It was developed by the U.S. Department of Health and Human Services in partnership with the American Hospital Association and the American Medical Association.

Step 1. Ask questions if you have doubts or concerns. Ask questions and make sure you understand the answers. Choose a doctor you feel comfortable talking to. Take a relative or friend with you to help you ask questions and understand the answers.

Step 2. Keep and bring a list of ALL the medicines you take. Give your doctor and pharmacist a list of all the medicines that you take, including non-prescription medicines. Tell them about any drug allergies you have. Ask about side effects and what to avoid while taking the medicine. Read the label when you get your medicine, including all warnings. Make sure your medicine is what the doctor ordered and know how to use it. Ask the pharmacist about your medicine if it looks different than you expected.

Step 3. Get the results of any test or procedure. Ask when and how you will get the results of tests or procedures. Don’t assume the results are fine if you do not get them when expected, be it in person, by phone, or by mail. Call your doctor and ask for your results. Ask what the results mean for your care.

Step 4. Talk to your doctor about which hospital is best for your health needs. Ask your doctor about which hospital has the best care and results for your condition if you have more than one hospital to choose from. Be sure you understand the instructions you get about followup care when you leave the hospital.

Step 5. Make sure you understand what will happen if you need surgery. Make sure you, your doctor, and your surgeon all agree on exactly what will be done during the operation. Ask your doctor, “Who will manage my care when I am in the hospital?”

Ask your surgeon:

     Exactly what will you be doing?
     About how long will it take?
     What will happen after the surgery?
     How can I expect to feel during recovery?

Tell the surgeon, anesthesiologist, and nurses about any allergies, bad reaction to anesthesia, and any medications you are taking.

More Information
Select for more information about medical errors. A Federal report on medical errors can be accessed online, and print copies (Publication No. OM 00-0004) are available from the AHRQ Publications Clearinghouse: phone, 1-800-358-9295 (outside the United States, please call 703-437-2078) or E-mail: AHRQPubs@ahrq.hhs.gov.

Five Steps to Safer Health Care. Patient Fact Sheet. AHRQ Publication Number 04-M005, February 2004. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/consumer/5steps.htm

view in PDF



Protect Yourself from Health Care Fraud


To avoid insurance fraud:

1.  Only visit your personal doctor, hospital or clinic for medical help. Only they should make referrals for special equipment, services or medicine.
2.  Never show anyone your medical or prescription records without first talking to your doctor or pharmacist.
3.  If someone calls and tries to threaten or pressure you into something – simply hang up the phone.
4. If someone comes to your door and says they are from Medicare or some other health care company shut the door…It’s shrewd to be rude!
5.  Do your homework and talk to your health care provider before buying or investing in internet “cure-all” or “miracle” products or services.
6.  Don’t keep mail in your mailbox for more than one day. People steal personal information right out of your mailbox.
7.  Rip up or shred your Medicare or other health care papers and other important documents before throwing them away. Crooks go through the trash!
8.  Treat your Medicare & Social Security numbers like credit cards. If someone offers to buy your Medicare or social security number, don’t do it…it’s simply not worth it.
9.  Remember that “Medicare” doesn’t sell anything.
10.  Follow your instincts—if it seems too good to be true, it usually is!
11.  If you suspect an error, fraud or abuse related to health care, gather the facts and report it.
12.  ALWAYS read your Medicare Summary Notice (MSN) or health care billing
statement. Your Medicare Summary Notice is the piece of mail stamped “This is Not
a Bill” that comes in after you get medical care. Look for three things on your billing statement:
• Charges for something you didn’t get
• Billing for the same thing twice
• Services that were not ordered by the Doctor

If you suspect fraud, call the National Insurance Crime Bureau’s hotline at 1-800-835-6422. For more information, check out www.insurancefraud.org


Are you covered for Short-term disability


Short-term disability is private insurance that replaces some of your income if an injury or illness prevents you from working. While you are away from work it pays you a percentage of your income for a defined period of time.

Some employers provide group policies as part of their benefits packages. If your employer does not offer short-term disability or you want additional coverage you can buy an individual policy from an insurance agent.

State temporary disability insurance (TDI) programs are currently available in six states/territories:

  • California
  • New York
  • New Jersey
  • Rhode Island
  • Hawaii
  • Puerto Rico (Spanish)

For a longer illness lasting six months or more your employer may provide group long-term disability (LTD) insurance. The Federal Citizen Information Center (FCIC) offers an LTD guide that includes information about individual disability income insurance and offers tips and a checklist on buying the right policy for you.

Social Security provides long-term disability benefits based on your salary and the number of years you have worked and contributed to the Social Security system. However, Social Security replaces only a limited portion of your salary, and the qualifications to receive benefits are very strict. To be eligible for Social Security disability benefits, all of these conditions must be met:

  • You have been disabled for five full calendar months.
  • Your disability is expected to last at least 12 months or end in death.
  • You are unable to be gainfully employed at any occupation, not just your occupation at the time your disability began.

Disabilityinfo.gov is the federal government’s web site for disability-related information and services. You may wish to access information about disability benefits, or locate state and local resources.

If you were injured on the job, you should contact your state workers’ compensation office.