Sikh Women's Health Initiative

If you’ve recently moved to the United States, figuring out the healthcare system can feel overwhelming. Don’t worry – we’re here to help! This guide will explain some basic terms and ideas about US healthcare, and talk about how it might affect Punjabi and Sikh women in particular.

Basic Healthcare Terms

1. Health Insurance: This is a plan you buy to help pay for your medical care. It’s like a safety net for your health and your wallet.
2. Premium: The amount you pay every month to keep your insurance plan active (even if you don’t use it).
3. Deductible: The amount you need to pay for healthcare services before your insurance starts to pay for things. For example, if your deductible is $1000, you pay the first $1000 of your medical bills each year. Only after this, your insurance will cover the bills.
4. Copay: A fixed amount you pay for a healthcare service, like $20 for a doctor’s visit.
5. Primary Care Physician (PCP): Your main doctor who you see for regular check-ups and non-emergency issues.
6. Specialist: A doctor who focuses on a specific area of medicine, like a heart doctor or a skin doctor.
7. Prescription: Medicine that a doctor orders for you, which you get from a pharmacy. Unlike some other countries, many medications, such as antibiotics, heart medication, strong pain medications, etc, are not available to everyone to buy at stores over the counter.
8. In-network and Out-of-network: “In-network” providers have an agreement with your insurance company, which usually makes them cheaper for you to see. “Out-of-network” providers don’t have this agreement and may cost more for you to see.

How US Healthcare Works

In the US, you usually need to have health insurance. You might get it through your job, buy it yourself, or qualify for government programs like Medicaid (for low-income individuals) or Medicare (for people 65 and older).

When you’re sick or need a check-up, you typically:

1. Make an appointment with a doctor
2. Go to the appointment
3. Pay your copay (if you have one)
4. Get treatment or a prescription if needed
5. Receive a bill later for any costs not covered by your insurance (for example if you have not met your deductible)

It’s important to know that in the US, you have the right to:

• Choose your own doctor
• Get a second opinion if you’re unsure about a diagnosis or treatment
• See your medical records
• Keep your health information private – no family member, friend, or anyone else can be told about your health unless you specifically give permission for the information to be shared.

How to Get Health Insurance

Getting health insurance is an important step in accessing healthcare in the US. Here are the main ways you can obtain health insurance. These options may feel overwhelming, so here is a simple summary:

1. Employer-Sponsored Insurance: Many companies offer health insurance to their employees. This is often the most affordable option.
   • If you’re employed, check with your company’s HR department about available plans.
   • You might be able to add your spouse or children to your plan.
2. Health Insurance Marketplace: If you don’t have insurance through work, you can buy it on your own through the government’s Health Insurance Marketplace.
   • Visit HealthCare.gov to learn about and compare plans.
   • You may qualify for subsidies to help pay for your insurance based on your income.
3. Medicaid: This is a government program that provides free or low-cost health coverage to eligible low-income individuals.
   • Eligibility varies by state.
   • Check your state’s Medicaid website to see if you qualify.
4. Medicare: This is a federal health insurance program primarily for people who are 65 or older.
   • Some younger people with certain disabilities also qualify.
5. Parent’s Insurance: If you’re under 26, you may be able to stay on or join your parent’s health insurance plan.
6. Spouse’s Insurance: If you’re married, you might be able to join your spouse’s health insurance plan.
7. COBRA: If you lose your job, you may be able to keep your employer-sponsored insurance for a limited time through COBRA, though you’ll have to pay the full premium.
8. Short-Term Health Insurance: These plans provide temporary coverage, usually up to a year. They’re an option if you’re between jobs or waiting for other coverage to start.
9. Pregnancy-Related Coverage: If you’re pregnant and don’t have insurance, you have special options:
   • You can enroll in a Marketplace plan at any time during your pregnancy.
   • Many states offer Medicaid coverage specifically for pregnant women, which typically lasts through your pregnancy and for 60 days postpartum.
   • Some states have extended postpartum Medicaid coverage to 12 months after birth.

Useful websites to learn more about health insurance options:

• HealthCare.gov: The official site for the Health Insurance Marketplace
• Medicare.gov: Information about Medicare
• InsureKidsNow.gov: Information about insurance for children and teens

Remember, having health insurance is very important in the US. It helps protect you financially if you get sick or injured. If you’re not sure which option is best for you, you can talk to a healthcare navigator. These are people trained to help you understand your insurance options. You can find a navigator through HealthCare.gov or your local community health center.

Special Considerations for Punjabi and Sikh Women

As a Punjabi or Sikh woman in the US, you might face some unique challenges:

1. Language: If English isn’t your first language, it can be hard to understand medical terms or explain your symptoms. Most hospitals and doctor’s offices offer interpreter services – don’t be afraid to ask for one! You do not need to bring someone to translate for you or worry.
2. Cultural differences: Some American doctors might not understand certain cultural practices or beliefs. It’s okay to explain your customs or ask for a doctor who understands your culture. If you feel unheard, it is okay to express this or change providers.
3. Family dynamics: In many Punjabi and Sikh families, health decisions involve the whole family. US doctors usually speak directly to the patient. If you want family members involved in your care, let your doctor know. Otherwise, it is your right to keep your health information private and no one will share anything with anyone without your specific permission.
4. Modesty: If you prefer a female doctor for certain exams or treatments, it’s okay to ask for one. Many clinics and hospitals can accommodate this request, especially for gynecological and obstetric care.
5. Mental health: In some communities, mental health isn’t talked about openly. Remember, mental health is just as important as physical health, and it’s okay to seek help. This does not mean you are weak, and you don’t need to share information with others if your family is not supportive. Many therapists now offer culturally sensitive care and can understand the unique pressures you might face.
6. Preventive care: The US system emphasizes check-ups and screenings to catch problems early. These might be less common in your home country, but they’re important for staying healthy. This includes regular mammograms, pap smears, and other women’s health screenings. Remember, these can help make sure you catch problems early or prevent them altogether.
7. Alternative medicine: If you use traditional Punjabi or Ayurvedic treatments, it’s important to tell your doctor. Some of these might interact with Western medicines. Share this with your doctor so they are aware.

Community Resources

Finding support within your community can make navigating the US healthcare system much easier. Here are some resources that might help:

1. Sikh American Legal Defense and Education Fund (SALDEF): They offer health education programs and can connect you with Sikh-friendly healthcare providers.
   • Read the Sikh Patients Guide for Healthcare Providers, and share with your providers at appointments, prior to procedures, during hospital admissions, etc. This can help them quickly understand your background, values, and how to incorporate aspects such as turbans, maintaining hair without shaving or cutting, and language and cultural barriers.
2. Sikh Coalition: They work towards civil rights for Sikh individuals and communities. This is not a health organization but has important tools you can utilize, such as this detailed guide for Sikh patients on what information to explain about yourself and your faith to your providers and an explanation on Sikhs and specific considerations.
3. South Asian Public Health Association (SAPHA): This organization focuses on public health issues affecting South Asians in the US and can provide valuable health information.
   • Visit the website for a list for health resources for South Asians in the US and by state
   • Mental health resources for South Asians
   • Cardiovascular Disease and Diabetes Toolkit
4. Local Gurdwaras: Many Sikh gurdwaras in the US offer health fairs, free clinics, or can connect you with Punjabi-speaking healthcare providers. You can find these resources online or ask about it next time you go to the Gurdwara.
5. South Asian women’s organizations: Groups which focus on women’s issues, including health, housing, counseling, food, and may offer support services specific to your needs
   • Sakhi for South Asian Women and Survivors
   • Manavi for gender-based violence
   • Ashiyanaa for support services for women and children impacted by domestic violence
6. Community health centers: Many cities have health centers that cater to immigrant communities. They often have staff who speak multiple languages and understand different cultural needs. You can easily look online for these resources near you or ask your healthcare providers at your next appointment because they often have lists or contacts.
7. Online communities and mental health tools: Websites like Mann Mukti and South Asian Mental Health Initiative & Network focus on South Asian mental health and provide culturally sensitive resources. There are countless mental health resources to support you, you can find some more options here.
8. University programs: Some universities have South Asian health initiatives that provide education and resources to the community.

What You Can Do

1. Ask questions: If you don’t understand something, ask. Healthcare providers are there to help you.
2. Bring a friend: If you’re nervous, bring a friend or family member to appointments for support. They can help you remember important information or questions you want to ask.
3. Learn about preventive care: Ask your doctor about important check-ups and screenings for women your age. This might include mammograms, pap smears, blood pressure checks, and diabetes screenings.
4. Keep records: Keep a folder with your medical history, prescriptions, and insurance information. Include any family history of diseases, as this can be important for your care.
5. Stay true to your values: Your cultural identity is important. Find healthcare providers who respect and understand your background. Don’t be afraid to switch doctors if you don’t feel comfortable or understood.
6. Educate your family: Share what you learn about the US healthcare system with your family members. This can help everyone stay healthier.
7. Take care of your mental health: If you’re feeling stressed, anxious, or depressed, it’s okay to seek help. Many therapists now offer culturally sensitive care and understand the unique pressures faced by immigrant women.

Remember, taking care of your health is important. It might take time to get used to the US healthcare system, but don’t let that stop you from getting the care you need. Your health matters!