The document provides an overview of navigating health care in the United States. It discusses key topics such as understanding health and illness from an American perspective, different types of medical care, rights and responsibilities of patients, emergency vs. non-emergency care options, health insurance programs like Medicaid and Medicare, and tips for staying healthy.

1. NAVIGATING HEALTH
CARE IN THE UNITED
STATES
Emily RN
Adjunct Faculty University of
Sioux Falls: Dept of Nursing

2. Understanding Health and Health Care
•If you are sick, get care as soon as possible so
that your health does not get worse.
•If you need care right away, go to the nearest
hospital emergency room.

3. Understanding Health and Health Care
•Most hospitals must treat you during
a medical emergency, even if you
cannot pay.

4. What is health?
• Health in your country may include body, mind and spirit.
• In the U.S., health focuses on the body.
• Body and mind are separate.
• To be in good health means the body is free of illness (disease).

5. What is illness or being sick?
• Illness or being sick in your home country may mean you are out of
balance.
• Restoring balance will make you well.

6. What is illness or being sick?
In the U.S., illness means that that there is physical disease.
This means that the body and parts of the body are not working right.
To restore health means to restore the body to good working order.

7. What is medical care?
• You may know medical care as a mix of science, traditional care, and
spiritual care.

8. Traditional Care
• Herbs
• Potions
• Prayer
• Acupuncture

9. What is medical care?
• In the U.S., medical care focuses on the body.
• It is based on science.
• It does not include spirit or religion.
• It often uses machines to test for and treat illness.

10. What is Medical Care?

11. In the U.S., you are responsible for your health
•You must be a partner
with your doctor or
other caregiver.
•You may talk with relatives
The final decisions
about care are yours.

12. You Have Rights!
• You have a right to be treated with respect.

13. You Have Rights!
• You have a right to have your questions answered.

14. You Have Rights!
• You have a right to participate in your care. You have a right to
informed consent.

15. You Have Rights!
• You may have a right to an interpreter.

16. You have a right to privacy.

17. Emergency Care
• Serious emergency care is needed for life-threatening or very bad
illness or injury.
• These might include:
• Heart attacks
• Serious car wrecks
• Bad burns
• Bad broken bones (bones that break the skin)
• Very high fever; convulsions
• Symptoms of stroke

18. Emergency Room

19. Symptoms of Heart Attack

20. Symptoms of a Heart Attack
• Symptoms of a heart attack can include:
• Discomfort, pressure, heaviness, or pain in the chest, arm, or below
the breastbone.
• Discomfort radiating to the back, jaw, throat, or arm.
• Fullness, indigestion, or choking feeling (may feel like heartburn).
• Sweating, nausea, vomiting, or dizziness.
• Extreme weakness, anxiety, or shortness of breath.
• Rapid or irregular heartbeats.

21. Symptoms of a stroke
• If you have symptoms of a stroke, call 911 or other emergency
services right away. Symptoms may include:
• Sudden numbness, tingling, weakness, or loss of movement in your
face, arm, or leg, especially on only one side of your body.
• Sudden vision changes.
• Sudden trouble speaking.

22. Symptoms of a Stroke
Sudden trouble speaking.
Sudden confusion or trouble understanding simple
statements.
Sudden problems with walking or balance.
A sudden, severe headache that is different from past
headaches

23. Emergency Care
• Emergency care might also be needed for less serious emergencies:
• Minor burns
• Cuts needing stitches
• Simple bone fractures (when bones do not break the skin)
• Asthma attacks

24. Non Emergency Care
• Routine care includes:
• Physical exams
• Well-child and well-baby exams
• Immunizations
• Regular tests (Mammograms, Glucose screening)
• Normal illnesses include:
• Sore throat or cough
• Fever
• Stomachache
• Earache
• Rash
• Mild injury (sprained ankle)
• Backache

25. Non Emergency Care at Clinic
• Emergency Care

26. Where can I get regular care?
• This may depend on what your insurance is or if you have any at all.

27. If you are insured…
• You may go to:
• Any person or place that takes your insurance.
• These include:
• Doctors’ offices
• Clinics, including community health centers and clinics in retail stores.
• Hospitals
• Ask your insurance company for help finding care.

28. I have no insurance, where can I go?
• Falls Community Health
• Contact Us
• Falls Community Health
• 521 N. Main Ave.
• Sioux Falls, SD 57104-5947
• Phone: 605-367-8793

29. Falls Community Health
• Providing an Open Door for Medical and Dental Care
• Falls Community Health’s mission is to be an open door to quality
health care services by removing barriers, especially financial, that
exist for working families without health insurance or other
resources to meet their health care needs.

30. Avera Downtown Clinic
• Health Care Clinic and Downtown Center - Avera McKennan
• 300 N Dakota Ste 117
Sioux Falls, SD - 57104
605-322-6800

31. What is the difference between Medicaid and
Medicare?
• A: Many people confuse Medicaid and Medicare. Medicaid and
Medicare are both forms of health insurance; yet eligibility for each
program is different. Medicaid is the state-federal funded program for
low income children and families, elderly and people with severe
disabilities. Medicare is a federally funded health insurance program
for Social Security beneficiaries.

32. Insurance facts
• Insurance Cards
• Deductible
• Co-Pay
• Monthly premium

33. Affordable Care Act
5 Things to Know for Healthy Individuals
• Under the health care law, insurance companies can no longer drop
you when you get sick just because you made a mistake on your
coverage application.
• Parents have new options to cover their children. If you have
children under age 26, you can insure them if your policy allows for
dependent coverage.

34. Affordable Care Act
• Job-based health plans and new individual plans are no longer
allowed to deny or exclude coverage to any child under age 19
based on health conditions, including babies born with health
problems.
• Starting in 2014, if your income is less than the equivalent of about
$88,000 for a family of four today and your job doesn’t offer
affordable coverage, you may get tax credits to help pay for
insurance.
• Starting in 2014, if your employer doesn’t offer insurance, you will
be able to buy insurance directly in the Health Insurance
Marketplace

35. Medicaid
• Medical Benefits Card
• What does the card look like?
• It is a magnetic stripe, plastic card like the one show below. The
information on the face of the card includes the following:
• Last Name
• First Name and Middle Initial (MI)
• ID Number (9-Digit)
• Generation Number (3-Digit)
• DOB
• Sex
• Each individual household member is issued their own card.

36. Medicaid Card

37. Medicare
med·i·care
/ˈmediˈke(ə)r/
(in the US) A federal system of health insurance for people over 65 years of age
and for certain younger people with disabilities.

38. Prevention of Illness: The best medicine
• An ounce of prevention is worth a pound of cure.

39. Tips for staying healthy
• Drink the optimal amount of water.

40. Tips for staying healthy
• Eat a healthy diet.

41. Tips for staying healthy
• Wash your hands regularly.

42. Tips for staying healthy
• Get the right amount of sleep every night.

43. Tips for staying healthy
• Exercise regularly.

44. Final notes about Health Care in the USA
• Be persistent
• Keep appointments
• Try to see the same Doctor time after time
• Take medicines as prescribed
• Take responsibility for your care
• Health Care is changing
• More people will have access

45. Thank you!

46. Sources
• Web MD
• Center for Disease Control CDC
• Virginia Department of Health
• City of Sioux Falls website