What To Do For A Sprained Ankle If You Are A Member Of A Healthshare

Summer is around the corner and that means wedges and fun sandals to help highlight our toned tanned legs. But be careful as many of these cute footwear options can be the cause of a twisted or sprained ankle. One misstep can have you falling off your Louboutin’s and writhing in pain.

If this has happened to you you know several thoughts run quickly through your brain usually all at once. I can’t believe that just happened, did anyone see? The next question is, is it broken? You may gracefully try and get up adjusting your skirt and brushing the street dirt off your hands, but as you try and put your foot down a gasp comes out of your mouth and the pain travels up your leg. What’s the next step? No pun intended.

The Difference Between A Sprain And A Broken Bone

According to WebMD, there are 3 bones in your ankle, you may not know if one bone is fractured or broken, but with multiple breaks you will not be able to walk. Even with  a high tolerance for pain,  when you have broken bones you  cannot put weight on the limb.  In addition to the pain, there might be numbness or tingling.

A sprain happens when the ankle rolls outward but the foot does not cooperate and turns inward. You have ligaments that run across the  ankle and they should stretch nicely with movement. Think of a rubber band,  it stretches the farthest it can stretch but instead of snapping back nicely it went beyond its stretchy limits and now it has little tears and lost its stretchiness.  That is what happened to your ligaments, it needs to have time to heal to get its “stretchy” back.

How A Healthshare Handles Care

With a healthshare you have a team of concierge care professionals who step into action as soon as you contact them.

Whether it is through an app or a care logistic number this is your starting point. Their goal is to guide you to the best care at the right cost.  On this call they will ask for your symptoms and how the injury occurred, depending on your pain level and description of the injury they will help determine the best route for care, which could be:

  1. A virtual visit with a tele-health doctor
  2. Provide you with  imaging order to go directly to an imaging facility where they will do an xray 
  3. If there is a high degree of pain they may suggest going to urgent care, with some health shares they will coordinate the care and the visit may be included in your membership. 
  4. Or they may advise you to try the “RICE” method to ease your inflammation:
    • Rest
    • Ice
    • Compression (with an elastic bandage)
    • Elevation (ankle above the heart)

The goal is to get you the care you need, if you can see that the bone is broken and the pain level is off the charts, get to the ER. Contact the healthshare as soon as you are stable to loop them into what transpired.  Sidenote, this is a great question to ask when exploring healthshares, how they handle life  threatening situations.

The Difference Between Insurance And Healthshare Care

The biggest difference between receiving care from a healthshare care team and traditional insurance is you are not alone in the process.  It’s like having a nurse in the family that you can ask when you don’t feel well or are injured.  You are speaking with a caring individual who can help you figure out how to get better.   Not all healthshares operate the same and one plan may provide you with a digital form of payment for your in-person imaging or doctor’s visit while another type of plan may reimburse you after you submit the proper paperwork.  Prior to signing up with a healthshare do the research to see what type of plan fits your needs and budget the best.

What Is A Medical Need?

What if the sprain worsens or you re-injure the ankle and need surgery? Then it becomes a medical need, these may be injuries or illnesses that result in medical expenses. 

Healthshares may refer to this amount as an (MRA)  Member Responsibility Amount or an (IUA) Initial Unshareable Amount. Zion Health  defines a medical need as expenses related to the same medical condition, whether expenses for a single incident or separate incidents, will be shared as one need. The related expenses will accumulate toward the total need amount.

The amounts can range from $500-$5000 per occurrence.  For example, if surgery is deemed necessary  for your broken ankle and your MRA/IUA is $1000, that is the cost for care, the patient’s portion of the medical fee and your responsibility amount that you owe.  

The healthshare “pool” or “community” will share the remainder of the bill.  This is typically up to 3 medical needs per year so the max out of pocket for major medical expenses would be $3000. Again each healthshare is different and it is important to read through guidelines and membership terms to understand what is included in your health plan.  

Whether you choose to go barefoot or strap on some sexy heels watch your step. If you do accidentally put a little extra twist in your dance moves or miss that last step while reading the much awaited text, know that if you are a member of a healthshare you have a team of caring people waiting on the other side of the phone to help you get back on your feet again.

If you would like more info on how to choose the right healthshare check out the “See Plans” page at www.indipop.co


Melissa Blatt

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