Choosing the right insurance plan

Choosing the right insurance plan for yourself or a family member can be a daunting task, with hour’s online comparing plans that look like complicated algebra problems.  As an Office Manager with TheraCORE Physical Therapy I have the responsibility of verifying and explaining benefits to our patients before they begin therapy.  On a monthly basis, I am confronted with patients that do not have a basic understanding of their health insurance policy and its coverage.  It’s important to understand what you’re looking at before you choose the plan that is best for you.

This is where it’s useful to know a few health insurance vocabulary words. As the consumer, your portion of costs consists of the deductible, copayments, and coinsurance.

Deductible: the amount of money you must pay each year to cover eligible medical expenses before your insurance policy starts paying. This amount is paid to the providers who have rendered their services until the total deductible has been met.

Copayments: one of the ways you share in your medical costs.  You pay a flat fee for certain medical expenses (e.g., $10 for every visit to the doctor), while your insurance company pays the rest. With some plans copayments apply towards the out-of-pocket maximums.

Coinsurance: the amount you pay to share the cost of covered services after your deductible has been paid.  The coinsurance rate is usually a percentage.  For example, if the insurance company pays 80% of the claim, you pay 20%.

Out-of-pocket maximum:  the most money you will pay during a year for coverage.  It includes deductibles, copayments, and coinsurance, but is in addition to your regular premiums.  Beyond this amount, the insurance company will pay all expenses for the remainder of the year. Note: There are plans that do not include the deductible in the out-of-pocket maximum; in this case your total for a year would be your deductible + out-of-pocket maximum.

Premium:  the amount you or your employer pays each month in exchange for insurance coverage.

Phew! Now that you understand the lingo, it’s time to decide what you and/or your family needs from a health insurance plan:

A plan that pays a higher portion of your medical costs, but has higher monthly premiums, is better if:

·         You see a primary or specialist doctor frequently

·         You frequently need emergency care

·         You take expensive or brand-name medications on a regular basis

·         You are expecting a baby, plan to have a baby, or have small children

·         You’ve been recently diagnosed with a chronic condition such as diabetes or cancer

·         You plan on having an extensive surgery that will require months of rehab

A plan with higher out-of-pocket costs and lower monthly premiums is the financially smart choice if:

·         You can’t afford the higher monthly premiums for a plan with lower out-of-pocket costs

·         You are in good health and rarely see a doctor

·         You do not currently take expensive or brand-name medications on a regular basis

We’re almost done! It’s time to see what your options are with your employer or federal marketplace if you are self-insured.  Sometimes you may have the option to choose between a HMO and a PPO plan.  In the table below you will see a comparison of HMO, and PPO insurance plans. This will help narrow down which plan would best fit your healthcare needs:

Plan Type	Do you have to stay in network to get coverage?	Do procedures & specialists require a referral?	Best for you if:
HMO: Health Maintenance Organization	Yes, except for emergencies. This plan may be better if you don’t mind your primary doctor choosing your specialists for you. If you have not had a HMO insurance policy before, we suggest making a list of current doctors you currently see and would like to continue to see.  Check to see if they are affiliated with the Health Maintenance Organization you are choosing before going with this option.	Yes, Referral is required by your primary care doctor before scheduling further appointments for tests, imaging, and specialists.  Depending on the office, this process can take 1-2 days to 1-2 weeks.	You want lower out-of-pocket costs and a primary doctor that coordinates your care for you, including ordering tests and working with your specialists.
PPO: Preferred Provider Organization	No, but in-network care is less expensive.  Out of network care generally has a higher deductible and out-of-pocket max.  You choose which doctors/specialists you see.	No	You want more provider options and no required referrals.

It is important to look at your upcoming year and try to anticipate and plan for as much as you can.  Obviously accidents happen and cannot be planned for, but understanding what you needed from a health insurance plan in the past can help the decision making for your future.   Most health insurance plans cover physical therapy, however coverage may be limited depending on the carrier and plan you choose.  For example; some plans offer a 20 day maximum per calendar year, while others have a third party company managing the disbursement and payment of physical therapy benefits.  If physical therapy is a benefit you used in years past and feel that this may be something you will need in the upcoming year, ask the carrier for an explanation of this benefit.

At TheraCORE, we verify a patient’s therapy benefits before starting therapy.  If you ever have a question regarding what your therapy benefits are and would like one of our Office Managers to call and check, please do not hesitate to call one of our offices.  TheraCORE accepts most major insurance’s, and offers affordable self-pay rates.

The federal marketplace website offers snapshots of these costs for comparison, as do many state marketplaces.

·         https://www.healthcare.gov/

·         http://www.healthinsuranceindepth.com/quotes-ehealthinsurance.html

Amylynn Kucera
Office Manager
TheraCORE, Inc - Westmont, IL

Slow Your Workout

Boot camps, cross fit, high intensity interval training – the more intense the workout, the better.  Right?  I disagree.  We are led to believe that the only way to be thin or fit is to complete these workouts that make us feel like we are going to die!  But, most of the time these workouts are not necessarily making us healthier.  The Journal of Sports Medicine and Physical Fitness found that 3 out of 4 people performing these workouts injured themselves. We as physical therapists see many injuries as a direct result of these types of workouts.  They range in severity from herniated discs, and torn rotator cuffs to chronic plantar fasciitis or iliotibial band syndrome. All of these can be avoided by slowing down your workout!

I have this conversation with my patients every day. A slower, more deliberate workout will allow you to keep your focus on correct form, muscle engagement, breathing and stability of your joints.  Thus preventing injury!  I encourage you to try it, here’s how…

Cardio: The Journal of the American College of Cardiology published a study in 2015 that compared slow, moderate and strenuous running over 12 years and found that lighter runners had a lower mortality rate.  This may be due to the increase in inflammation and stress in the body caused by strenuous exercise. 

I often recommend a low-intensity interval workout that alternate between a fairly easy pace and one that’s slightly more challenging, like a walk/jog.  A great way to start is walk for 2 minutes, then jog for 1 min, repeat this for 20 minutes. This training style burns more calories than working at one steady pace for the same amount of time because the body is repetitively speeding up and slowing down. 

Strength:  Lifting less weight with fewer reps and at a slower speed can actually increase your strength more than the traditional 3 sets of 10, lifting with 1-2 second reps.  And, more importantly, save your joints!    Try this: Use a smaller dumbbell, take 5 seconds to go up, 5 seconds to go down and only perform 5 reps. 

Also, take more time between workouts.  Research shows it takes your body three days to recover between strength sessions. It’s during that time that your muscles get stronger and more defined, so adding more workouts will only break you down, not tone you up!

Flexibility: Pain from chronic overuse injuries often results from a lack of flexibility.  Foam rolling and stretching are two things I do with every patient.  However, these things need to be done slowly so the muscles can relax and release. 

Foam roll an area for at least 1 minute at a time.  Stop and hold an area that feels tight or sore, taking deep breaths to allow relaxation.  It can be sore and painful the first few times rolling, but will provide great benefits to your overall fitness. When stretching, hold the stretch for at least 1 min and perform 2-3 reps of the same stretch.  It takes about 2 months to improve flexibility with performing these things regularly, so have patience!

Of course a high intensity workout can provide a fun challenge every once in a while, but I challenge you to try a slower workout day to day.  You’ll see your health and overall fitness improve without the risk of injury.

Amy Goebbert, PT, DPT

TheraCORE, Inc.

Massage for Pain Relief – September is Pain Awareness Month

September is here! Kids are back in school, busy summer nights are over and summer vacations have come to an end. September is also Pain Awareness month. Pain Awareness Month is a time when various organizations work to raise public awareness of issues in pain and pain management. 

While most people would agree that a massage feels good and that it can be great for relaxation it is often considered an indulgence. As a pain relief strategy, therapeutic massage can be an effective tool. While there are different types of massage, they all work by manipulating the soft tissue. Therapeutic massage may relieve pain in several ways, including relaxing painful muscles, tendons, and joints; relieving stress and anxiety; and improving blood circulation to the affected area.

There are many benefits of massage for both pain management and overall health and wellness.

Massage for Pain Management

·         Alleviate low-back pain and improve range of motion.

·         Enhance immunity by stimulating lymph flow—the body's natural defense system.

·         Exercise and stretch weak, tight, or atrophied muscles.

·         Help athletes of any level prepare for, and recover from, strenuous workouts.

·         Increase joint flexibility.

·         Promote tissue regeneration, reducing scar tissue and stretch marks.

·         Pump oxygen and nutrients into tissues and vital organs, improving circulation.

·         Reduce post-surgery adhesions and swelling.

·         Reduce spasms and cramping.

·         Relax and soften injured, tired, and overused muscles.

·         Release endorphins—amino acids that work as the body's natural painkiller.

·         Relieve migraine pain.

Health and Wellness Benefits of Massage

·         Decreased anxiety

·         Enhanced sleep quality

·         Greater energy

·         Improved concentration

·         Increased circulation

·         Reduced fatigue

·         Creates a general feeling of well-being

Massage for pain relief helps minimize your physical pain and alleviates the stress and anxiety associated with it. How often should you get massage to reap the benefits of addressing pain? It’s different for everyone. What we do know is you’ll get better results if you are on a regular schedule — whether it’s monthly, weekly, or some other formula that works for you. The best thing to do is work out a treatment plan with your massage therapist and start feeling better!

Kerri Ames, LMT

TheraCORE, Inc.                                                                  

Lockport, IL

Staying Hydrated

Now that we are in the dead of summer heat, it is even more important that we stay hydrated. While we are all continuing our exercise routines, watching our kids or friends with their outdoor sports, or just enjoying the summertime sunshine it is sometimes easy to forget to keep drinking.  Drinking water helps keep us hydrated when we loose water from sweating, or just daily breathing, helps keeps us energized, balances electrolytes, and helps with weight control! With more fluid intake needed in the summer months, it can sometimes get boring to always reach for the regular water; here are some alternatives for hydrating in a tasteful and more exciting way without all the added sugar.

o   Try using the summertime sunshine to brew sun tea! Fill a clear container with water and place any combination of teabags you like (about 8 tea bags per 1 gallon of water).  Let sit in the sun for several hours until the water turns color, pour over ice and add citrus rings for added flavor and some natural sweetness: orange, lemon or lime slices would taste great!

o   Try adding fresh seasonal fruit, vegetables and herbs to add natural flavor to your water!

o   Watermelon Cubes with Mint leaves

o   Pineapple Cubes

o   Cucumber and Ginger slices

o   Citrus rings: orange, lemon and lime

o   Apple Slices with Cinnamon Stick

o   Strawberries and Lime Slices

You can also use frozen fruit that will help to chill down your drink and act as a flavorful ice cube or make your own infused ice cubes! 

o   Add blended fruit, vegetables and herbs to ice cube trays and freeze. When you run out of the house needing water, add a few cubes, (one, or any combination!) to your water for an infused water experience. As the ice cubes melt it will slowly infuse flavor into your water. (You could also add these to your sun brewed tea!).

o   For each combinations below blend with 1 ¼ cup water and freeze until solid

o   Juice of 1 lemon (add zest for extra flavor), 1 inch piece of ginger

o   Juice of 2 limes (add zest for extra flavor), 8-10 seeded cherries

o   1 cup Watermelon cubes, ¼ cup mint

o   1 cup strawberries, ¼ cup basil

o   ½ cucumber, ¼ cup mint leaves

o   1 cup cantaloupe, 1 cup honeydew melon

o   1 apple with sprinkle of cinnamon

For any of the combinations, change the proportions based on your taste preference-make them weaker or stronger! Experiment until you find your favorite combination!

- Casey Harms, RD,LDN

To schedule a Nutritional Counseling appointment with Casey Harms, contact your nearest TheraCORE, Inc. clinic.

Burr Ridge (630)590-5409 - Lockport (815)838-5070 - Westmont (630)908-7430

Back To School - the unconventional student

Congratulations! If you are reading this blog it means you have already overcome a huge obstacle on your path to furthering your education; deciding to go back to school.  Let me first start out by defining the “unconventional student.” This is typically an adult student.  As an adult, there are a variety of different responsibilities other than school that will have to have time and energy devoted to them; such as, children, maintaining a home, marriage, and work. Starting or going back to college can be both physically and emotionally draining. It can be terrifying to change careers, intimidating to enter a classroom after many years. How could I forget about student loan debt! Don’t panic! I have been an unconventional adult student for four years and will graduate this August from Lewis University with a Bachelor’s degree in Athletic Training. From there, I am preparing to further my education in Physical Therapy School.  With this blog I will hopefully relieve your fears and give you some tips and tricks to accomplish your goal of higher education. 

First, I want you to ask yourself “Why am I going back to school?” You could be working toward an increase in salary, pursuing a dream or goal that was put on the back burner, or simply making a shift in careers. This question is important because if you are not 100% motivated to take this step, it will be much harder to tolerate the stress. As for me, I enlisted in the army right out of high school and spent seven years working as an infantryman in a special operations unit.  Unfortunately, I was injured on a deployment and ended up medically retiring.  This injury led me to my passion of helping others in the field of Athletic Training and Physical Therapy, as I relied heavily on physical therapy to be able to walk again. I can honestly say that I would not have been able to finish my undergraduate training if I did not truly enjoy what I was studying.  I also have a wife, a child, three dogs and a new home.  I work part time and the majority of my schooling requires unpaid clinical rotations and an internship.  As you can imagine, sometimes I feel as though I am stretched pretty thin.  Luckily, I have learned to prioritize.  Obviously, coursework is a priority, but it cannot consume your whole life.  You have to make time for your kids and significant other.  One thing I have found to be helpful is a good schedule and a routine.  A few tips for this are to register and enroll early.  Adjust your work schedule to your class schedule and block in study and homework time. I tried to leave a one-hour break between classes to finish homework.  I usually leave either all of Saturday or all of Sunday dedicated to family time and do not do any coursework during that time.  Sometimes, a break is necessary to regain motivation. Wake up at the same time, leave your house at the same time, and go to bed at the same time.  In addition to keeping a good schedule and routine, keeping physically active and following a nutritious diet is essential.  I played hockey for three years of my college career, and being active 5 times a week helped keep my energy up and gave me a release from stress.  I recommend doing what you enjoy, walking, jogging, yoga, interval, HIIT, cycling swimming or sport participation.  Being active 30-minutes a day for four to five days a week can help keep your head in the game.  Many people get bogged down by diet.  Don’t count calories or macronutrients. I found you will not have time.  Develop a diet of “clean eating” with a balance between proteins, carbohydrates and fats.  Meal prepping will be vital to staying on track.  My wife makes my lunch, so I get some assistance in this area.  Diet is important because poor food choices or not eating enough will lower your energy and may affect your ability to be successful. Staying hydrated by drinking plenty of water will further assist a healthy diet.  For me, coffee was necessary and so drinking plenty of water to offset the dehydrating effects of caffeine was helpful.

           

No matter how motivated and organized you are, sometimes the stress of life wins and its okay.  I have had many instances where I could not sleep, could not focus on coursework and was neglecting my family because I was not able to handle being pulled in multiple directions.  I was still accomplishing things but I was just going through the motions. One thing that really helped me is a technique called “mindfulness.” This technique teaches you to focus on breathing to put yourself in the moment. It teaches you to recognize when your mind wanders and to get your focus back on the present. I have found this to be very beneficial, although, it did take some time and effort to really recognize the positive effects.  With that being said, I believe that having a strong support system is the most beneficial thing you could have. Having my wife, family, great coworkers and friends to seek advice from or just vent to is a great way to alleviate any stress or doubt.  Sometimes you need to be vulnerable and ask others for help. Think about who you have on your team and make sure they know how much you appreciate their help.

           

Remember to love what you are doing, develop a scheduled routine, stay active and eat well, utilize various techniques to combat stress and take advantage of your support systems.  Everyone has their own methods and techniques, so do what works best for you.  I have just tried to give you some pointers that have benefitted me on my path.  Below I have provided several links to help you on your way.  You will do great things!

-Brad Hojek

Aide at TheraCORE Physical Therapy

http://www.mindfulnet.org/page2.htm

https://www.psychologytoday.com/blog/the-mindful-self-express/201202/nine-essential-qualities-mindfulness

http://www.menshealth.com/nutrition/beginners-guide-to-meal-prep

http://www.apa.org/monitor/2011/12/exercise.aspx

Can kids be physically active during screen time?

As my boys reach their teen years, it seems to be a constant battle keeping them off their phones and video games.  With all the extra hours at home this summer, getting them off the couch isn’t as easy as it used to be!

It is recommended that kids get at least 60 minutes of vigorous play each day to stay healthy.  Regular exercise in nature is proven to improve children’s physical and mental health.  Outdoor activity helps kids maintain a healthy weight, boosts immunity and bone loss, lowers stress and improves self-esteem.  It is also recommended that screen time be limited to less than 2 hours a day.  That’s TV, video game, computer, phone and iPad total time less than 2 hours/day!  I don’t know about you, but I find that to be nearly impossible. 

So, what about creating ways to be physically active with screen time?  Pokémon Go had the right idea and got my kids up and walking around, but they outgrew that game. Here are some other ideas I have used with my boys…

·         When watching morning cartoons or an afternoon movie on a rainy day, see how many push-ups you can do or how long you can hold a plank at the commercial breaks.  Make it a contest between you and your kids!

·         Allow them to create a private (only those you share the video with can see it) You Tube channel where they can create and post videos of themselves doing something active.  My boys will make a highlight video of themselves doing tricks on our trampoline, or dunking on the basketball hoop, or doing skateboarding tricks and set them to music.  They turn out pretty impressive!

·         Play a game on your phone together.  We like Heads Up where you hold the phone on your forehead and try to get your partner to say the words that pop up on the screen.  Even though it’s a talking game, we are always up jumping around acting out the word!

·         We still have a blast playing Wii sports together. Whether it be baseball, tennis or golf, the competitions get pretty intense.  And, they get a good laugh out of how bad I am. Just Dance or Outdoor Challenge are other fun active video games.

Of course, the goal is always getting outside with my kids hiking, biking, kayaking or just a good old game of one-on-one in the driveway.  Sometimes you have to pick your battles, and if getting them active with screen time is the best I can do some days, I’ll take it!

Amy Goebbert, PT, DPT

Co-owner & Physical Therapist - TheraCORE, Inc.

Outdoor Adventures

It’s Summer! Round of applause!!!

You complained all winter about the dreary weather and now that hibernation season is over, why are you still Netflix binging on the couch?! The sun is out and the weather is as good as it will be all year, so why not give the great outdoors some love?

As you’ve likely heard, exercise has loads of evidence on positive health benefits. Let’s spend a little time elaborating on a couple of my favorites: hiking and kayaking.

Hiking

While you won’t find a large mountain to climb in IL, you will find several local and not so local parks and canyons to explore.

To name a few:

• Starved Rock
• Matthiessen State Park
•       Shawnee National Forest
• Giant City State Park
•       Fern Cliff State Park
• Rock Cut State Park

Health Benefits of Hiking

• Fight off heart disease. Those who do not exercise are twice as likely to have coronary heart disease.
• Lower your blood pressure. Physical activity lowers BP 4-10 points. Regaining a normal body weight can lower it 5-20 points.
• Manage and prevent diabetes. Exercise can reduce the amount of insulin needed and can potentially reverse the course of the disease for those with Type II.
• Improve your cholesterol levels.
• Lose and maintain a healthy weight.
• Decrease your risk of colon cancer.
• Fight stress. Walking releases adrenaline thus helping to decrease tension and anxiety.
• Increase bone density and slow the rate of calcium loss responsible for osteoporosis.
• Manage osteoarthritis. Motion is lotion! Walking is a low impact activity good for assisting with maintaining strong, healthy bones and muscles.

Kayaking

Pick a lake. Burn calories. Rest. Enjoy scenery. Repeat. All while getting tanned and toned. Who can argue with that?

Health benefits of Kayaking

• Take in extra Vitamin D necessary for healthy bones.
• Improved breathing efficiency and cardiovascular endurance.
• Decreased fat and increased lean muscle mass. Think strong arms, legs, back and core.
• De-stress. Being by water is shown to assist with relaxation and with the endorphins from exercise, it is a win-win!

Take home: regular exercise has been proven to have a positive effect on lengthening and improving the quality of our lives. You want to be around to complain about next winter right? So, what are you waiting for? Get outside!

Katie Green, PT, DPT