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Oregon Health Insurance Marketplace

By April 22, 2019 No Comments

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Health insurance plans are often stereotyped as an "additional expense" rather than a "valuable investment". Know how you can have affordable health care thru the Oregon Health Insurance Marketplace.

Oregon Health Insurance Marketplace: Everything You Need to Know About Health Insurance

Aside from the moist rain forests and fertile valleys that swathe the geography of the Pacific Northwest, Oregon is also packed with a rich culture. American-born European descendants dominate the population of Oregonians. Sadly, not all of them recognize the benefits health care insurance coverage provides. Thanks to the breakthrough of the Oregon Health Insurance Experiment in 2008, health plans in Oregon have gained the recognition they deserve.

Low-income, uninsured adults are drawn through a Medicaid program lottery and selected for a restricted number of available spots. Execution of this method aims to filter those who are eligible and not able to apply for Medicaid. The random selection also paved the way for researchers to discover the many benefits of health care for the public and showed the state of Oregon government the advantages of public health insurance.

The first one to two years of Medicaid coverage demonstrated effects on health care utilization, financial hardship, health, and labor market outcomes. Simultaneously, Medicaid observed an increase in health care utilization, decrease in financial strain, and lower depression rates. If the health insurance exchanges proved to be positive for the health insurance provider, then it is even more helpful for the citizens of Oregon.

Benefits of Health Insurance Coverage

Medicaid coverage resulted in a significant increase in outpatient visits, hospitalizations, prescription medications, and emergency department visits. These findings suggest that without benefits such as individual health insurance people tend to keep to themselves and endure a lot more than they can handle. But when covered under Medicaid, these recipients had lower medical debt.

Beneficiaries of insured plans receive other awards as well. Here is a list of what you can get when you sign up for health insurance.

  1. Inpatient Care
    Insured people can seek inpatient treatment in a hospital or any health care facility from a partner of their insurance provider and get the medical attention they need without fear of huge financial impact.
  2. Outpatient Care
    This variation allows patients the freedom to leave the facility once their procedure is over as long as there are no serious complications. One advantage to this is patients can recover in the comfort of their own homes rather than being confined in a hospital room. There are also fewer costs incurred from outpatient procedures.
  3. Laboratory Tests
    People need more routine check-ups and laboratory tests than they may think. Having blood, urine, or body tissues examined regularly will help doctors diagnose medical conditions as early as possible. The results also assist in the planning or evaluation of treatments and can monitor previously diagnosed diseases as well. Insured people do not have to worry about lab test costs.
  4. Prescription Drugs
    Patients must have a check-up before a doctor can recommend medications. However, health insurance coverage will pay for both the doctor visit and the prescribed drugs.
  5. Preventive Services
    Screenings such as check-ups and patient counseling can prevent illnesses, diseases, and other health-related problems are covered under insured plans. Thankfully, the US Affordable Care Act required the majority of health plans to ensure clients with a set of preventive services without requiring copayments, coinsurance, or meeting deductibles before receiving certain preventive services.
  6. Recovery Services and Devices
    Whether you are injured or have a disability or any chronic condition, there are services and devices available through insurance plans to help you recover. Some of the inclusions are physical and occupational therapy, speech-language pathology, and psychiatric rehabilitation.
  7. Emergency Room Insurance
    Accidents are inevitable, and the emergency room is among the most costly of the average American patient’s medical bill as it often includes ambulance transportation, ER doctors, equipment tests, and emergency medication. Investing in health care to cover these costs can save you from more expensive fees later.
  8. Mental Health and Substance Use Disorder Services
    There are also policies that cater to people with special needs and require particular attention. Sometimes, these two conditions occur together, with one subsequently leading to the other. Covered treatments may include behavioral health treatment, counseling, and psychotherapy.
  9. Pregnancy and Childbirth Care
    The cost associated with pregnancy and childbirth can cause trepidation in women when considering motherhood. However, all prenatal, delivery, and postpartum care is included in comprehensive insurance plans.
  10. Pediatric Services
    Adults are not the only ones who need medical coverage; kids do, too. While getting an additional plan for your children means another expense for you, it is less than you would have to pay in the event of an uninsured accident or illness.

Health insurance plans are often stereotyped as an additional expense rather than a valuable investment. The World Health Statistics tells us “too many people are still dying of preventable diseases” and “too many people are unable to get the health services they need.” Therefore, it is imperative people stop looking at health insurance as just an expensive commodity, but rather a basic necessity.

The Oregon Health Insurance Marketplace

Trust is vital in this industry, and Oregonians need something to rely on when it comes to substantial health care. The Oregon Health Insurance Marketplace is where people can find the right Oregon health plan for them. Guaranteeing that available health insurance plans on HealthCare.gov are compliant to state and federal requirements, the Oregon Health Insurance Marketplace offers Oregonians the assistance and assurance in seeking health insurance that works best for their personal needs and budgets.

  • Obtain Financial Assistance
    This cost-sharing reduction gives people allowances to pay less when they get health care services. They can enjoy such benefits if they enroll in a silver plan through HealthCare.gov. While most enrollees qualify for financial assistance, there are also a few who are eligible for lower out-of-pocket costs.
  • Contract Health Insurance Plans
    Every single county in Oregon has access to private health insurance plans through HealthCare.gov. With multiple plans available in each area, no matter where in Oregon you live, you can rest easy knowing you can participate in open enrollment for 2019.
  • Redeem Dental Plans
    As part of the Oregon Health Insurance Marketplace coverage, clients can also choose from a variety of dental plans.
  • Special Options
    Oregon is home to diverse cultures and races, and these services are available for everyone. Private and public plans alike also cater to Native Americans and Alaska Natives as their individual beneficiaries. Enrollees of a federally recognized tribe are eligible for this specification.
  • COFA Premium Assistance Program
    Low-income citizens of the Republic of Marshall Islands, the Federal State of Micronesia, and the Republic of Palau who currently reside in Oregon have exclusive privileges. They can apply for the Compact of Free Association (COFA) Premium Assistance Program which grants them free health insurance.

The Oregon Health Insurance Marketplace will assist you in finding local help, coverage, and guidance even for those who are already covered.

Different Plan Options You Can Choose From

Before choosing a particular health plan, you must know the distinctions of every single policy. What may work for one might not be right for others. You should also take note of the different plan options you can choose from.

  1. PPO
    The Preferred Provider Organization plan is a group health insurance policy which makes a network of preferred doctors and hospitals available to employees. With its flexibility, convenience, lower premiums, and large choice of providers, PPO could be the best option for your small business and your employees.
  2. HMO
    The Health Maintenance Organization Health Insurance plan allows for a lower out-of-pocket expenses for employees and provides a broader range of coverage in terms of preventive services compared to other policies. However, there are usually fewer options for physicians and hospitals than in other plans.
  3. POS
    The Point of Service health insurance policy is a combination of the features of HMO and PPO. This option is a balance of greater provider choice and lower premiums.
  4. EPO
    The Exclusive Provider Organization plan is similar to that of HMO in that they employ an exclusive network of physicians who their members must use, with an emergency as the only exception. Members are responsible for small copayments, and may sometimes require deductibles.
  5. Indemnity Health Insurance
    This policy is best known for its fee-for-service plan. Predetermined amounts or percentages of costs are paid to the member for their covered services. However, members may still be held responsible for deductibles and coinsurance amounts. Some members opt to pay first using their own money and then file reimbursements for the covered amount.
  6. HSA
    The Health Savings Account insurance plan is another alternative to traditional group health insurance. HSAs are tax-favored and can be attached to other group health insurance plans by the employer or not.
  7. QSEHRA
    The Qualified Small Employer Health Reimbursement Arrangement is a health insurance benefit suitably designed for small businesses with fewer than 50 employees. This option provides employees their monthly allowance of tax-free money which members can use toward a health care service of their preference. Individual health insurance is included in this policy.

Whether you are seeking a policy for yourself, your family, or your business, there is a perfect option out there for your qualifications and needs. However, you must first recognize the value a comprehensive health insurance policy offers you, and then you will know without a doubt you are getting your money’s worth.

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