Navigating the health care system: no matter what happens with health reform over the next year, big changes will take time. So you still need to be savvy about how to get the best possible care at the best price for yourself and your family

National Women's Health Report, March, 2009 by Pamela Peeke

Here's what I've learned over the years from being on both sides of the issue.

* Know your policy. Do not, repeat, do not, expect your health care professional or his or her office staff to know what your policy covers. They are typically dealing with a dozen or more health plans, and it is impossible for them to be familiar with the benefits and networks of each.

* Save everything--every communication from the insurance company, every bill from your health care professional's office, every receipt for a co-pay or deductible payment. Insurance companies (and offices) make mistakes.

* Evaluate the available plans during open enrollment. Think about what your family's health care needs and how much you typically spend in a typical year. If you are fairly healthy and don't need much medical care, then a plan with a high deductible and low premium might be best; but, if you have a chronic condition that requires ongoing care, make sure you can afford the out-of-pocket costs.

* Be your own health advocate. That means checking into the hospitals, labs and specialists to which you are referred rather than simply taking your health care professional's word that they are good. It means questioning diagnoses or treatment recommendations if they don't sound right to you; making your health care professional aware of any side effects or problems you have with the treatment; and following up on tests if you haven't heard back from your health care professional's office. Tests can get lost.

* Track your medical history. Until we have a national system of medical health records, you have to be your own medical health record. This is particularly important if you have a chronic condition like diabetes or cancer. Keep a running list of every health care professional you've seen (including phone and address), every test ordered (and the results), every drug you've been given (and the side effects). Give a copy-to every new health care professional. Then when you tell her you had a colonoscopy three years ago, you can also tell her who did it so she can get a copy of the results.

* Take your medical records with you when you move. Give your health care professional's office a week or so to get them together. Make a copy. Give one copy to your new health care professional and keep one for your files.

* Communicate. Talk to your health care team. Get to know them so they can get to know you. Be honest about your personal habits like drinking and smoking and about your lifestyle--relationship issues and exercise. Trust is the foundation of any relationship in the health care system. If you don't trust your health care professionals, it's time for a change.

RELATED ARTICLE: Practice Preventive Medicine

The best way to navigate the health tare system is to stay out of the system. That means staying as healthy as possible.

- Schedule screenings such as mammograms, colonoscopies and Pap tests.

- Follow a healthy diet low in salt, sugar and saturated fat and high in fruits, vegetables, lean protein and whole grains.

- Get regular exercise. I'll settle for 30 minutes a day, but an hour or two a few times weekly would be best.

- Wash your hands. There's simply no better way to prevent infection. Carry a little bottle of sanitizer with you-and use it!

- Take your medicine as directed. The blood pressure pills, asthma inhaler and antidepressants don't make you feel better immediately; they're designed to control your condition over time so it doesn't flare up and land you in the emergency department or hospital.

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By Pamela Peeke, MD, MPH NWHRC Medical Advisor

Dr. Peeke is a Pew foundation Scholar in Nutrition and Metabolism, and Assistant Clinical Professor of Medicine at the University of Maryland in Baltimore. She writes about health and lifestyle issues important to all women.