Health Insurance 101
Like most people, you probably have some questions!
Do I need it?
Having health insurance has traditionally been a way of protecting yourself against unexpected medical bills (similar to car insurance, where you pay for coverage with the hopes that you won't get in an accident, but if you do, you have protection). If the unexpected happens, this can make a huge difference, for example, an average 3-day hospital stay in the USA costs $30,000! Unlike auto insurance, where you are required to be covered to operate a vehicle, you are not required to have health insurance to live your life. However, you would need to decide if not being covered is worth the risk for you. And, there may be additional financial penalties for not being covered (more on that later.)
How does it work?
Depending on which plan you choose, you're usually responsible for paying for a certain amount of "out of pocket" costs, like copayments for doctor visits, before your insurance company starts paying for the rest. (What are copayments and out-of-pocket expenses? Check out this helpful guide to insurance lingo here.)
It's important to make the most of your health insurance by understanding what's covered on your plan, and where you should go for care before you are seen for services. (Often, insurance plans require that you see providers in their 'network', or to pick up prescriptions at a specific pharmacy in order to get your benefits.) Just call the member services number on the back of your card before any service, and let them know where you are going, what you are going in for, and what you can expect for coverage. Many plans now offer benefits info online too. Being armed with this information upfront helps you, and your medical provider, navigate the best and most affordable options for you.
Can I use it at Bridgercare?
Insurance is happily accepted at Bridgercare, whether you qualify for sliding fee scale discounts or not! Payments from your insurance plan help us to be here for you with affordable services, and it helps you out with costs too. (Remember to check your plan benefits to make the most of your coverage!) And, any time you have questions for us, you can ask to talk to someone in the Billing department at Bridgercare.
Why are politicians always talking about it?
In 2010, President Obama signed the Affordable Care Act (also known as Obamacare or the ACA) into law. The ACA changed health insurance as we knew it in the USA by requiring insurance companies to make changes like:
young people could stay on their parent's insurance until age 26
insurance companies could no longer deny health coverage to people with "pre-existing conditions" (this huge pre-existing conditions list included pregnancy, depression, and being trans)
insurance companies could not charge sick people more than anyone else to have health coverage
insurance plans had to start covering services, starting with "essential health benefits" like preventative visits, annual exams, and birth control without any co-payment from the member.
Even more changes here. The ACA also required that people have health insurance or potentially pay a tax fine for not having insurance. Because of this, insurance had to be accessible and affordable. Enter Open Enrollment in the Marketplace.
The Marketplace offers discounts based on income, through tax credits, to make paying monthly premiums affordable. You can sign up for one of these plans during Open Enrollment (which is from Nov 1 to Dec 15th this year) unless you qualify for a Special Enrollment Period (find out here.)
Since the ACA, there has been a lot of debate among politicians about whether to keep it, whether it needs to be fixed, or whether to repeal it altogether. Reforming our healthcare system in the U.S. is an ongoing process and one we expect to continue to see debated in Congress in the years to come. It's important to let your elected officials know where you stand and what your concerns are so that they can best represent you. Find your elected officials here.
Have more questions about your health insurance? Give Bridgercare a call at 406-587-0681!-Shannon, Office Manager and 1/2 of the Billing Department Team @ Bridgercare