5 Ways to Navigate the Health Care System Like a Boss Parent

It's more important than ever to know the ins and outs of the health care system. From picking the right doctor and medical costs to boosting your kid's immune system, here's everything you need to know.

sick girl eating soup with tissues around her
Photo: Priscilla Gragg

From colds to COVID, it's hard to predict what this season might throw your way. But what you can know is how to prepare. Consider this your cheat sheet to navigating America's sometimes complicated health care system.

1. Pick the Right Doc

Looking for a pediatrician is less about finding the absolute best in the world and more about finding a good fit for your family. For example, for some, that might mean a doctor who is Latino and who, as a result, has more familiarity with health issues prevalent in the Latino community, such as asthma, and with whom it may be easier to build trust. Feeling comfortable is key to getting the best care, says Jane L. Delgado, Ph.D., president of the National Alliance for Hispanic Health. In fact, studies show that people who see a doctor of their same ethnic or racial background are more likely to open up at appointments. "If you don't feel completely welcome when you are at a pediatrician's office, then do not go back," Dr. Delgado says.

For those who would prefer a pediatrician of color, don't be shy about asking friends, fellow parents, and coworkers for recommendations. HUEDco.com is a free tool for locating doctors of color in your area, and AyanaTherapy.com offers a similar service to search for licensed mental-health therapists.

It's always a good idea to schedule a meet-and-greet with a physician, in person or virtually, before you commit. And ask questions: How many patients of color do you see? What's your experience with multigenerational households? Have you ever studied a second language? There's no right answer to these questions, but if a doctor brushes them off, that's a red flag to look elsewhere. Trust your gut.

2. Manage Medical Costs

Do shop around.

When your first-grader has a bean lodged in their nose, you're probably not going to spend time comparing prices to get it removed. But for some procedures—like an MRI, speech evaluation, or allergy panel—it pays to ask about pricing up front, as it can vary wildly. ClearHealthCosts.com allows you to see prices, narrowed down by both location and procedure, while Guroo.com compiles millions of insurance claims to show the average costs for certain exams at the national, state, and local levels.

Don't avoid the doctor to save money.

After all, pediatricians are trained to catch and diagnose conditions early, says Silvia Pereira-Smith, M.D., a Venezuelan mom and assistant professor of behavioral pediatrics at the Medical University of South Carolina.

Do speak up.

Personal finances can feel taboo to bring up at the pediatrician's office. But in reality, your child's doctor may have a wealth of resources at their fingertips, from abundant samples (formula, bandages, nasal saline, hand sanitizer…) to simple cost-cutting strategies, such as prescribing medications in bulk. They'll also know that it's important to confirm that tests or procedures are necessary (rather than routine) and covered by insurance.

Don't fill scripts on autopilot.

Studies show that generic medications typically cost 80 to 85 percent less than brand-name equivalents. Be picky about filling prescriptions too. Some insurance companies reward members with lower prices for using preferred pharmacies. Price-comparison tools like GoodRx.com and LowestMed.com make it easy to search for deals. Sometimes it's smartest to get your meds without going through insurance. At stores like Costco and Walmart, you'll see up-front prices that can sometimes, depending on your coverage, beat your prescription co-pay. Also check out the Partnership for Prescription Assistance (MAT.org) as well as Needymeds.org.

3. Plan for the E.R.

Taking a family member, especially a child or aging parent, to the emergency room is never going to be stress-free. But doing a little homework in advance can help things go a lot more smoothly.

Figure out your route.

The nearest E.R. may not always be your best option. For instance, children's hospitals often have pint-size equipment and staff that are more experienced in treating kids. Ask your family's doctors to see whether they have recommendations about where to go. And check with your insurance company to see if they have a preferred location (which can save you money).

Load your wallet.

You've probably already got a photo ID and credit card. But double-check that your insurance card is up-to-date and safely stashed in there as well. Tucking $10 in cash into an out-of-sight pocket will ensure you can buy water in the waiting room. And since there's always a chance that you won't be able to accompany an elderly parent into the E.R., prepare their wallet as well. If you're worried language will be an issue, include a letter explaining that they speak Spanish or another language and will need an interpreter, along with your contact info.

Get records in order.

Electronic health files are increasingly common, and your kid's pediatrician may already have a patient portal and can give you access. You can also create your own on an app like Apple Health. Or go old-school with a notebook or binder. Just be sure to jot down any previous illnesses, surgeries, immunizations, allergies, chronic conditions, prescriptions and dosages, regular supplements, and OTC meds. Keep these physical records in a tote bag with other essentials (extra phone charger, a stuffed animal or game for your kid, snacks) that you can easily grab in case of emergency.

sick girl receiving a hug and kiss from mom
Priscilla Gragg

4. Consider Telehealth

In-person appointments are crucial for well visits and to diagnose certain conditions (hello, strep!). But there are plenty of times—follow-ups, checkups for chronic illness, therapy—when connecting by screen will do the trick, says Aura Obando, M.D., a Colombian mom and pediatrician at Boston Health Care for Homeless Program.

To get the most out of any virtual visit, talk to the doctor in a private, well-lit area so you're comfortable chatting freely about symptoms and they can easily see your kiddo, Dr. Pereira-Smith suggests. Set up your laptop or mobile phone on a table so there's less distracting movement during the session, and write down a few notes beforehand about the symptoms or questions you want to ask so you won't feel too rushed or miss anything. "And, just like an in-person visit, it can be helpful to give your child a small toy or something to entertain them while you talk," Dr. Pereira-Smith says.

5. Boost Your Family's Immune System

These small, daily habits can help rev up infection-fighting defenses.

Embrace bedtime.

The pandemic has upended many of our normal routines, especially if family members are working or learning remotely from home. But "children who are well rested have stronger immune systems," says Kimberly Montez, M.D., a Mexican-American mom and assistant professor of pediatrics at Brenner Children's Hospital, part of Wake Forest Baptist Health in Winston-Salem, North Carolina.

Cook the rainbow.

You know fruits and veggies are packed with vitamins, minerals, and antioxidants—all of which play a crucial role in keeping your kid's immune system humming, Dr. Montez says. But people tend to eat less produce in the winter. Beat the trend this year by embracing more cold-weather fruits and veggies, such as citrus, squash, sweet potatoes, cabbage, and persimmons. If your kids aren't keen on five servings a day, aim to bump up their intake by just one serving a week. Small improvements add up over time.

Get active.

There's strong scientific evidence that regular exercise can reduce the number of times someone catches the cold or flu in a year, possibly because it helps the circulation of infection-fighting cells. To make daily activity a habit, build it into the schedule (say, a post-nap walk around the block or a predinner scooter session), and don't let low temps trap you indoors. Sledding, snowman building, nature scavenger hunts, and snow tubing are all great ways to build a sweat—and memories.

Bring on the sunshine.

Soaking up some time in the sun has been linked to everything from improved mood and sleep to—yes—stronger immune function. Scientists think that it might be thanks to vitamin D, aka the sunshine vitamin. A 2020 study suggests that increased vitamin D could help boost the expression of hundreds of genes that are thought to play a role in immune function. Just be sure to wear sunscreen, even in winter, Dr. Montez advises.

Don't Forget The Flu Shot!

Influenza vaccines aren't 100 percent fail-proof, but they're a safe way to decrease the odds that your child will get seriously sick. "That's especially important this winter because coronavirus and flu will coexist," says Nancy Silva, M.D., a Brazilian-Portuguese mom and pediatrician in Wesley Chapel, Florida. "Some kids may contract both, and it's much harder to fight two potentially deadly infections instead of one alone."

Particularly for multigenerational households, she stresses the need for everyone to get a flu shot, from your kid to Grandma. You can get vaccinated "even into January or later," according to the CDC. And many pharmacies offer on-site flu shots without requiring an appointment, though ask about age restrictions before heading over.

Containing COVID-19

Even when your family is doing their best to wear masks, wash hands, and practice social distancing, someone may still come in contact with the virus. Just because one person tests positive doesn't mean everyone will inevitably get sick. In fact, though the research is still emerging, early studies show that within-household transmission rates hover at around 19 percent. Here's how to keep as many of your family members as possible clear of the coronavirus.

* Quarantine the sick family member in one room and designate a bathroom for their use only. Add a HEPA filter at the entrance of a quarantined room, if you can, for increased protection for others in the house, suggests Dr. Silva.

* Pick one caregiver to tend to the sick family member. Don't have that person also care for kids in the house.

* Wear gloves to handle the sick person's dishes, glasses, and utensils (and consider disposable options), and avoid touching your nose, mouth, and eyes. Discard gloves and wash your hands well afterward.

* Ask the ill family member to wear a mask whenever they're around other relatives (yes, even shuffling down the hall to the bathroom).

* If possible, open windows and turn on fans in rooms to circulate clean air from the outdoors.

A version of this article originally appeared in Parents Latina's December/January 2021 issue as "Winter Health 101."

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