Stretching Your Health Care Dollars

Spring FlowersThe unbelievable price of health care in the U.S. sometimes makes it difficult to hold to the idea that one’s health is more valuable than anything else.  Although I know, instinctively and from experience, that without good health nothing else matters, it has been very hard for me to justify the spending at times.  I suspect many of you feel the same.  I learned a lot navigating those expenses over the last few years and I wanted to offer some practical ideas on how to decide when and where to spend, when to pull back, and how to do as much self-care as possible.

1)  Adjust your lifestyle for the greatest amount of self-care.  This kind of goes without saying, and you probably already know it if you are here reading, but you need to change your life to give yourself the best possible chances of optimal health.  Stop with all the excuses.  I honestly think that you should dedicate the bulk of your health care spending here.  Prioritize your budget for maximum self-care.

Here’s where to start:

  • Change your diet.  I, obviously, think an AIP template is a good place to start.
  • Reduce stress.  Be radical about this.  Job too stressful?  Quit.  Seriously.
  • Prioritize good sleep.  There’s lots of good info on the web about how to achieve this goal.
  • Exercise.  I have a very simple, low-impact walking routine.  You don’t have to be fancy, just move.
  • Get outside.  Sunlight and interaction with the natural world matters.
  • Form a support network.  You’re not an island, quit trying to conquer your health challenges alone.

2)  If you have health insurance, do your very best to understand your plan and benefits.  Then be prepared to fight.  Yep.  I just said that.  My experience is that the insurance company is counting on you NOT following up on things.  If you feel they have denied payment incorrectly or have not paid what they are obligated to pay, dedicate time and effort to getting your full benefit.  You may also need to work this same approach with providers and hospitals.  Again, I believe in many cases they are counting on you NOT paying attention.  I realize this is extremely stressful and energy draining work.  Try to find a partner that can help you stay on top of reviewing bills and seeking maximum benefit from your insurance plan and providers.  I did this job alone for several years, but when I got very ill and overwhelmed with the task, my husband came on board.  Now together we are usually able to save substantial amounts of money.

If you don’t have health insurance spend as much time as you can learning about the health care options that might be available to you.  It is not hopeless.

3)  At the same time you are learning about your insurance plan and benefits, find a primary care doctor that is in-network AND right for you.  It’s really important to find providers in-network as it can save you thousands of dollars over the long-haul.  You can usually tell within one or two visits if a doctor is right for you.  If it isn’t a match, move on quickly and keep trying until you have exhausted the primary care doctors available in-network.  This relationship has to be as good and as inexpensive as possible.

Here’s what I think makes a good primary car doc:

  • Caring, respectful bedside manner
  • Conducts VERY thorough annual physicals 
  • Practices or is at least familiar with functional medicine
  • Takes time to answer most of my questions
  • Is familiar with a Paleo lifestyle and ideally supports it
  • Is familiar with my autoimmunes (if a doc talks to me about Celiac in an out-dated way, the visit is over)
  • Is willing to discuss and order (when necessary) testing I want done and willing to discuss and refer me (when necessary) to specialists

4)  Get the most complete, thorough annual exam you possibly can and then make the most of every bit of information you gain from the testing.  Particularly pay close attention to your lab results.  Take time to learn what ideal levels, NOT lab normal ranges, are for the various vitamins, minerals, etc. that are covered.  There are lots of good websites that can help you learn what certain tests are, why they are conducted, and how to understand ranges.  If you see results that are questionable, even if your doctor seems to feel they are acceptable, schedule a follow-up to talk about them.  This is your chance to advocate for yourself and potentially identify and correct health problems before they get out of control.  Prevention is the key.  Go to every appointment with a complete list of questions and concerns.  If you get overwhelmed during appointments, take a partner with you to ensure all issues get addressed.  

In addition, if there are tests that can be routinely done for you to stay on top of your AI, learn all you can about those tests and have them conducted at regular intervals.  For example, a Celiac should know everything about antibody testing and have it done regularly after diagnosis.

5)  Once you’ve got a good in-network primary care doctor and had a really thorough physical, I recommend finding a really good alternative practitioner.  Who you choose and what their specialty or training is can vary a lot, but just focus on finding someone who is very knowledgeable, not focused on selling you products, and well-fitted to your needs and traditional health care team.  Ideally this person can guide you on less-invasive approaches to restoring health, recommend specific testing to help you identify underlying issues that the traditional system does not recognize, and suggest medicines/supplements that would be valuable to your care.  (If state laws or your insurance plan let you call an alternative practitioner your primary care doctor and cover those services, that is the ultimate ideal.  Congrats!  You only need one provider.)

Through alternative practitioners I learned about my gluten cross-reactivity status, discovered parasitic infections that needed treatment, uncovered a pancreatic insufficiency and found out about genetic mutations that required me to modify my health approach.  All of that information was very valuable and changed how my traditional doctors treated me.

6)  Now comes the hard part . . . how do you know when to say when?  When is it time to stop spending so much and pump the health care brakes?  This is where I am at right now.  I’ve come to the point that I can start being much more selective.

Here’s how I decide when NOT to spend:

  • It’s a repeat test and I now know how to look for the symptoms and diagnose myself without testing.   An example of this is SIBO.  I know when I have a SIBO now.  I don’t need to go through the long, annoying, expensive test anymore.
  • It’s an expensive test not covered by my insurance and the information it will provide is not crucial to my health care at this time.  An example of this is the Metametrix GI Effects test.  We’ve paid for this test out-of-pocket twice now and I’ve learned extremely useful info, but I probably don’t need to repeat for a long time.
  • It’s a very invasive test and the information it will provide is not crucial to my health care at this time.  An example of this is an endoscopy.  I’ve had three endoscopies in the last two years.  To be honest, I just can’t put myself through another one for a long time.  I had to draw a line for myself.
  • I’m having a scary health problem, but I know the ER is not necessary.  I know now how to distinguish between a major medical emergency and the scary, but not life threatening, symptoms of my AIs.  If I am very worried, I go to an urgent care and get their advice on how to proceed.  It is much less expensive, not to mention less stressful, than the ER.  (Naturally I am not advocating skipping the ER if you need it, just saying that if you understand your health challenges well now you can be more judicious in how to treat them.)
  • It’s an expensive supplement that I can potentially get from a food source or I can wait to add to my routine.  I do a lot of research on supplements and seek out expert opinions before buying now.
  • It is an expensive complementary care, but I don’t notice a major benefit within 30 days.
    An example of this might be acupuncture or massage, etc.  I saw a physical therapist regularly for awhile.  It was helpful, but did not impact my health in a major way after the first 30 days, so I did not continue.

Do you have some really great tips or creative ways to stretch health care dollars?  Have a story about how you stopped the spending spiral?  Tell me about it!

About Angie Alt

Angie Alt is a co-founder here at Autoimmune Wellness. She helps others take charge of their health the same way she took charge of her own after suffering with celiac disease, endometriosis, and lichen sclerosis; one nutritious step at a time. Her special focus is on mixing “data with soul” by looking at the honest heart of the autoimmune journey (which sometimes includes curse words). She is a Certified Health Coach through the Institute for Integrative Nutrition, Nutritional Therapy Consultant through The Nutritional Therapy Association and author of The Alternative Autoimmune Cookbook: Eating for All Phases of the Paleo Autoimmune Protocol and The Autoimmune Wellness Handbook. You can also find her on Instagram.


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