Want Better Healthcare? Check How ‘Public Option to Obamacare’ Delivers

It was almost five decades back when there were certain actions taken to help the poor and the elderly population of America, received some relief in health care costs. With the federal government of USA introducing Medicaid and Medicare, citizen of the U.S. received certain relaxation in medical aids. In 2010, after almost half a century, President Barack Obama again took the initiative of coming out to help the needy and the constrained population of America. Patient Protection Affordable Care Act (PPACA), or Affordable Care Act (ACA), or Obamacare (more of a colloquial term) has come up with some sort of relief for every needy soul of America. Today, after 6 years of its successful implementation, President Obama has come up with an additional benefit ‘public option to Obamacare’ for the people of America.

Health care expenditure can be a major cause bringing severe damages to health in the United States of America. Expensive treatments, prescriptions, drugs, hospital stays, laboratory tests, all can even make a person go bankrupt. However, the long-standing hindrances in providing adequate health care to the people of USA seem to be finding solutions with Obamacare ultimately. Ever since ACA was enacted into law, the following changes have been observed over a few years time, like:

• The rate of uninsured people in the US have reduced to 43%
• 2010- 16.1% US citizen were uninsured
• 2015- 9.1% people remain uninsured
• estimated reduction in middle aged unable to afford health insurance coverage to 5.5%
• Federal goverment could reduce its debt towards collecting $600-$1000 for each enrolee to health insurance plans
• Reduction to about 3.4% in middle aged people reporting poor health conditions
• The health care payment process too has transformed. Around 30% of the traditional payments of Medicare are flowing through the alternative models of payment.

All these and more such reforms have made serious contributions to sustained time period of spending on health sector for every insuree. Yet, there’s lot more that has to be achieved to achieve the target.

Changing how the health care system delivered

Earlier, when ACA wasn’t introduced, the health industry depended mostly on free service payment system by individual donors. The system would levy penalty on those organizations that who did efficient delivery while they were incapable of rewarding better quality care providers.

With modifications in health coverage law and further adding health option, those organizations can now provide those advantages that health insurance plans like Medicare and Medicaid were given better payments. The goal is to align them better with the actual costs that come in providing care. With changes in Medicare payment plans, the private sector too received decreased price in the health expenditure.

ACA helps detect health frauds

Many policies were included in Obamacare to identify and prevent frauds that happen in the health insurance sector. Higher scrutinization before someone gets enrolled into Medicare or Medicaid to prevent high rates of fraud prevalant in the domain. If any organization was found incurring more than $1 million loss, were charged stronger penalties to prevent such crimes. Implementing the “value based payment,” where Medicare related systems tie up with different health care enterprises and professionals for fee-for-service paying. There are efforts to foster a health insurance market

5 Vitalities to Remember While Buying Health Insurance Plans Arizona

So, you finally realized you require a health insurance? And, you have tried reading all kinds of material trying to figure out how to go about it. I am sure you have all sorts of questions looming in your head-

• Will I be able to afford a health insurance?  
• What will be provided for Arizona? 
• What will get covered when I fall sick? 
• Who do I go to for a good health insurance plan for Arizona?

If you have begun with your research, you may have already heard of the penalties you pay in case of being uninsured. And if you haven’t, it’s better are aware that you pay penalties while submitting your tax details in case you are uninsured. And there is nothing to get jittery about buying a health insurance plan. If you have right resources and facts, you can easily make smart decisions about which insurance you should buy.

There is detailed information available in the health insurance marketplace, making it easier for you to compare the various available plans. You can check and then easily pick a plan that perfectly fits your budget. This blog is to help you with the 5 vital factors you need to remember before buying your health coverage deals:

1. Where should you look: on or off the health insurance marketplace (exchange)?

This condition applies only for those who intend to buy their plans personally (not offered by employer)

To buy personal health insurance plans in Arizona, you have two choices- buying them through the state’s exchange, or not, i.e., off the state exchange.

There are insurance companies that provide plans both ‘on’ and ‘off’ the exchange. In case your income falls below 400% of the federal poverty level, you may get some premium discounts issued in your plan. However, these discounts work only and only when you buy the plan through the health insurance marketplace or exchange.

While, in ‘off’ the exchange, there are some plans, which may have wider network in terms of providers of health care.

2. You must get your “SBC” for comparison

Always collect the summary of benefits and coverage (SBC) to make proper comparisons. The health reform legislations mandate every insurer to provide information about their plans. This is a ruling from the federal government that the plans should be explained in a standard, plain- language in terms of SBC. You can also ask for a glossary on the terms used in health insurance coverage and healthcare.

3. What will be the actual cost?

For every health insurance seeker in Arizona or anywhere else in USA, price is usually the prime criteria before picking any coverage plan. While, people mostly concentrate on the premiums they need to shell out, it is also necessary to go beyond what you are billed for in EMIs. You must check what you are paying out-of-pockets and what deductibles have been associated to your plan.

It is usually better to pay a little higher premium and have a less cost- sharing plan. 

To understand the cost-sharing, you have to read various health insurance plans.

4. Networks of your provider: are your doctors in the coverage? Do you require taking benefits outside-your-network?

For any plan you buy, you need to check if the doctors you wish to visit or other healthcare providers are in the same network as is in the plan. In certain cases, networks are different according to the plans, even so within same insurance companies. Also, it is better you ask your agency about it rather than depending on the insurer directory.

5. Do you have your medicines under the plan, what is their cost if they do?

There are separate lists of medicines for every health insurance plan. These are called formularies. You must check what medications your plans cover and which not. There are usually specified tiers for assigning covered drugs. The cost-sharing of the drugs for patients will depend upon the plan chosen. Even if the medicines are covered within the plan, there are different tiers allowed for each plan, which you need to check carefully.

Even when you have checked all the above vitalities to buy your health insurance in Arizona, it is always better to take assistance from a healthcare broker. The nature of healthcare and the design of different health insurance plans are a little complicated. Even if you think you understand everything, it is better to get clear understanding from an expert. Also, you may not receive all the information of your health plans from different resources online. A proper health insurance agent in Arizona will be able to provide you clearer picture of the marketplace. 

Impact ObamaCare Has Made on New Mexico

Are you planning to shift to New Mexico, or have you been living in the state for some time now? The first thing that you will have to consider, of course after you have found yourself a decent accommodation, is- what different issues will impact your health. You may even wish to find out how the state covers its residents with affordable health care and coverage. Well, it is true that NM remains infamous when counting on its people insured however, things are changing ever since the new Obamacare has been implemented.

Of course, before you jumped into conclusions about health insurance in New Mexico being pitiable, you need to look at the challenges it faces:

• It has the highest percentage of children and uninsured living in complete poverty
• Rate of drug deaths are really high
• Rate of school graduation quite low
• State funding on public health lowered by 10 percent
• High rate of violent crime and preventive hospitalizations

However, not everything about this state is bad. This state is possibly one with very low amount of air pollution. You will rarely find obese people and binge drinking is not a practice here. Moreover, affordable medical insurance New Mexico plan was initiated in 2014, to increase the access and affordability of health insurance to its residents. 

The implementation of Affordable Care Act (ACA) or Obamacare, amidst major differences between the republicans and democrats (remember the Ryan-Biden debate), actually changed the marketplace of health insurance across the USA:

In 2012- 2013, around 24% New Mexicans within 25 and 60 were uninsured- 4th highest in USA.	In 2014, the rate fell to 19.6% non-elder NM residents remaining uninsured.
In 2012- 2013, about 20.2% of the New Mexicans of all ages were uninsured.	Come 2014 end, the rate dropped to 15.3% remaining uninsured.

Under the ACA, there are five different health plans that have been designed. These are:

• Bronze Plans- Comes with lowest monthly premiums, where 60% of the medical cost gets borne by the insurance company.

• Silver Plans- The actuarial value is 70%, which means the company bears 70% of the medical expenses.
• Gold Plans - Premiums go higher with higher metal value. Gold has 80% actuarial value. Hence, your insurance company will pay 80% of the medical bills.
• Platinum Plans-You pay more monthly premium, you get more coverage on your medical bills. This health insurance plan in New Mexico gives 90% actuarial value, which means 90% of your health coverage is covered by the insurance company.

• Catastrophic Plans- Exclusive plans for those aged below 30 and they come with low premium, essential benefits and high deductibles.

Now that you are aware of the different health insurance coverage under Obamacare, the next thing you will want to know is the plan that will fit you. It is not at all a difficult process to find an affordable health insurance in New Mexico. Just fill in your essential details like your birth date, vital statistics (Height/weight), gender, basic health data, and your contact details. There will be available plans shown to you based on your location and the kind of health profile you possess. From there you can either choose to take a health insurance agent who lives nearby or connect to the resource center online. Certain basic questions will be asked to you in the resource center, like:

•    Do you wish to take an individual plan?
•   Do you have a small business here?
•    Do you fall under pre-existing conditions?
•    Do you come uninsured in New Mexico?
•    Do you already possess a New Mexico health insurance?
•   Do you wish to get an Obamacare exchange?
•   Do you wish to get an exclusive Obamacare quote?
•   Do you need the guide to New Mexico Obamacare?

Depending upon which section you fall under or, what specific information you wish to gather, you can collect all the materials you require. Once you have decided with your plan and need to execute the process of getting your medical insurance, you can visit the official healthcare site for filling in your details. 

How impactful has ACA been in New Mexico?

With all the above values shown and execution path described, an extremely relevant question will arise on how much impact has Obamacare or affordable medical insurance New Mexico been able to make. You must ensure your safety and protection before you get into any kind of long term investments, especially when it concerns your health plus, a sumptuous amount of your hard earned money.

More affordable, accessible and high quality

According to the reports available, ACA has managed to create more affordability to the US citizen in healthcare. The plans are of high quality, highly accessible, and designed after carefully observing the demographics of the people of New Mexico.

High numbers re-enrolling into health coverage

There were 52,358 customers of NM who got re-enrolled automatically into the new scheme. Throughout entire USA, about 11.7 million people were enrolled automatically in this marketplace.

 New Mexico gets $123,281,600 grants under Obamacare

The state has total grants of $123, 281, 600 to implement in the researching, planning, development of IT, followed by its implementation in the health insurance marketplace. While all open enrollments had been time-capped, enrollment for CHIP (children Health Insurance Program) and Medicaid is open all year round. The aim behind ACA was to reduce the total number of uninsured people in USA. New Mexico alone saw some 4.9% increase in its health insurance number in just one year’s time.

Retain children insurance till 26 years age

Moreover, there are new options of coverage made available to the young adults. Children are allowed to keep their insurance under mostly all conditions till they reach 26 years of age. This has reduced tremendous pressure on students who are graduating from colleges and universities and have an added burden of paying their education loans.  

Medicaid coverage expanded

With new ACA, states now can expand their coverage through Medicaid. Those with family income under 133% of the poverty level, or earning less than $32,253 per annum (four people in the family) will get extra coverage from Medicaid. The plan includes even non-elderly adults who don’t have dependent children. This category was earlier not covered under Medicaid.

To add more to the platter:

• 74% consumers of NM who signed up were given a tax credit of $196/month using the marketplace.
• Of those who enrolled in the NM marketplace, 49% got coverage paying $100 or less, if they had applicable tax credits. 84% of the total consumers were given the option to use.
• Earlier in 2014, consumers could choose from only 4 plans. In 2015, another issue got added and consumers can now choose from 5.
• There were a total of 36 health plans in 2014, which has been increased to 43 health insurance plans- more options for the consumers of NM.
• 29% or 15,143 consumers under 35 years are signed for medical insurance in New Mexico, and 21% or 10,965 consumers within the age of 18 and 34 years signed up.

With the new presidential elections coming round, which party and who comes to live in the White House will probably decide if Obamacare stays or has to exit. However, the changes it has made into an average American’s healthcare situation are phenomenal. For states like New Mexico and others who have been rather not adequately catered to by the federal government, Affordable Care Act or Obamacare sure looks like a healthier lifestyle choice. 

Top 11 Things Health insurance companies Look At When You Apply

Millions of us now have health insurance under Affordable care act or Obamacare but health insurance is often confusing for new people who wants to enroll or the members who are already enrolled in health care plans but are not familiar with the terms of insurance. So before buying insurance, here are some of the facts you have to know which the insurance companies are looking at:

• Medical history:  past and current medical conditions such as diabetes, depression, will play a bigger role in determining your policy cost.

• Tobacco use: Tobacco and nicotine users will pay 4 times more on average for their policy.

• Body type: your height/weight plays a big role in the policy cost. Being just a few pounds overweight can mean paying 25% more.

• Blood Pressure: High blood pressure, hypertension is a common cause for higher premiums.

• Cholesterol: Make sure this is under control. High levels or Chol/HDl ratios mean high premiums.

• Family History: It hardly seems fair, but the presence of cancer and heart problems in your family could impact your policy.

• Hazardous activities: If you are fond of Scuba diving, rock climbing, racing cars, then these could all cause you to pay a little more.

• Foreign Travel: Travel to countries considered dangerous will result in higher premiums or even a declined application.

• Income: It is surprising but you must qualify financially for the amount of term life insurance amount of term life insurance you want.

• Driving Record: Easy on the gas, Mario, multiple moving violations mean you will pay more. A DWI/DUI means you’ll pay a lot more.

• Citizenship: U.S. citizen living in the U.S.? No problem. Living abroad? That will depend on the country. Foreign nationals will need a valid Visa.

 Things to Do Before Buying Health Insurance:   

• Be sure to disclose all medical conditions on the application.

• Gather all physician contact information and medical history notes you may have.

• Discuss your situation with your agent and ask her/him to shop for the best company.

• Visit health insurance marketplace where you can shop, compare and enroll in affordable health insurance plans over a variety of plans from different health insurance companies.