Healthcare is expensive, and most people cannot afford to pay the full cost of services. Instead, most people buy insurance to help pay for healthcare costs (Figure 2.12). Most people get insurance through their employer or purchase insurance from a health insurance marketplace. Other health insurance options, available through the US government, include Medicare and Medicaid. Medicare is insurance available for people 65 years of age and older. Medicaid pays for healthcare costs of people living in poverty, pregnant people, older adults, and people with disabilities. Because of the Patient Protection and Affordable Care Act (ACA), young people can get coverage through their parents’ or guardians’ insurance through age 26. Skills for Health and Wellness Creating a Health Management Plan As you get older, you will take more and more responsibility for your health. This might include talking more during doctor appointments, making your own doctor appointments, and changing your behaviors to improve your health today and in Practice Your Skills Set Goals A health management plan contains the goals you set for your health and wellness and the actions you take to reach them. To set goals and determine the actions in your health management plan, use the following steps: 1. Assess how you feel in your life right now. How is your physical health? Do you wish you were faster or stronger? How are your mental and social health? How are you managing your stress, and what relationships give you support and love? 2. Make a list of the areas of your health you would like to improve. Then, set four realistic goals about your health. Some examples of these goals might include seeing the doctor once a year, talking to a therapist, choosing not to have sex, running outside to relieve stress, or making two good friends at school. 3.● Make each goal SMART: ● Specific: Clearly state what you want to accomplish. ● ● Measurable: Define the quantifiable result that will mean you achieved the goal. ● ● Achievable: Break out the actions you will need to take to achieve the goal. ● ● Relevant: Make sure the goal fits you, your values, and what you want to accomplish. ● ● Timely: Set a realistic and specific time line for achieving the goal. Decide how you will monitor your progress and reward yourself for achieving the goal. Once you have all the details about your four goals, go through them with a trusted adult and a trusted friend. Seek feedback from these people and ask them to help hold you accountable to follow your plan. At your next doctor appointment, talk with your doctor about these goals and ask for advice about goals you might set in the future. the future. To help change your health and behaviors, you can create a health management plan, or an outline of actions for improving your health and wellness. This kind of plan includes your health goals related to all areas of health. Figure 2.12 Both HMO and PPO insurance plans involve people making co-payment, deductible, and premium payments. Payments Main Types The Basics of Insurance Health maintenance organization (HMO) ● ● Pays for the costs of basic healthcare services and many other specialized services ● ● User must use doctors, hospitals, clinics, and services that are members of the HMO network Preferred provider organization (PPO) ● ● Pays for the costs of healthcare provided by doctors, healthcare providers, and hospitals ● ● Allows for more flexibility in choosing providers, but is more expensive Premium ● ● A regular fee paid to the insurance company each month ● ● Paid even if you do not receive medical care Deductible ● ● Amount a person pays for healthcare services before the insurance company begins to pay for an agreed-upon portion of healthcare costs Co-payment ● ●● A fixed amount for medical services ● For example, you might need to pay $20 for a visit to the doctor Copyright Goodheart-Willcox Co., Inc. 52 Unit 1 Promoting a Lifetime of Health and Wellness