Since 2014, DMV HEALTHY INSURANCE has engaged individuals, families and business by providing assistance in selecting and enrolling in health insurance plans, navigating the health exchanges, and educating clients on the costs and benefits.
“We strive to improve the population’s health and provide helpful information and resources. We are creating informed consumers of healthcare services,” says Nigel Graham, DMVHI’s owner.
Here, Graham provides best practices when deciding on an insurance plan, insight for gig workers and the self-employed, and states how insurance companies committed to diversity, equity and inclusion best serve communities.
What impact does the lack of health insurance have on individuals and families?
It has a wide-ranging impact from prenatal care and mental health services to eldercare services. Many uninsured are not getting the preventative services that are essential to detect diseases early. Nor, are they receiving the treatments that help improve outcomes.
The health insurance marketplace can be overwhelming and daunting. What are some tips you can offer individuals when choosing plans? If you have had COVID, does it affect your health insurance rate?
If you have a preexisting condition, including Covid-19, you cannot be denied coverage when enrolling in an ACA plan.
It would help to consider these things before enrolling on the health insurance marketplaces:
- Do you have a current primary care physician (PCP)?
- What insurance do they accept?
- Does the plan have a deductible? The deductible is the amount of money the member must pay first before the plan begins paying for the covered services.
- Does the plan have an out-of-pocket maximum? The out-of-pocket maximum is the most a member could ever be responsible for paying in a plan year. This means it puts a cap on your financial responsibility. The plan would pay one hundred percent of the covered costs when you have reached your maximum amount.
Without an insurance plan, you would be responsible for 100% of the medical bills.
What kind of affordable plans are available for the gig worker, entrepreneurs, and small business owners who don’t have the advantage of being a part of an employer network?
For small business owners, there are plans available through the Small Business Health Options Plans (SHOP). In December, the plans waived the employee participation requirement and the employer contribution requirement for eligible businesses. Some group plans only require one employee to enroll. Self-employed and gig workers should seek coverage through the individual marketplace first.
What are the major factors that affect your health insurance rates? Provide at least three.
Some factors that can affect a person’s health insurance rate can be the cost of medication. If your medication is a specialty or non-generic, it may not be a part of the carrier’s formulary. Where you live, if there is a very high utilization rate, some insurance companies will not include it in the service area. Lastly, the type of plan you select HMO, PPO, POS will determine your rates. If you want to see a specific doctor, whether in or out-of-network, a PPO plan may work better, but you will pay more for having that option.
What are health insurance providers doing in the space of Diversity, Equity and Inclusion?
Many providers recognize the benefits of having a diverse staff to treat patients and understand how to align with their culture and tradition. They have increased community engagement through initiatives that help members purchase healthy foods and hiring employees that reflect the communities they serve. There is always room to improve, but these are positive steps in the right direction.