Oregon Health Insurance Marketplace and Its Strategies

Aside from the moist rainforests and fertile valleys that swathe the geography of Oregon, this constituent state of the United States of America is also packed with a rich culture. American-born European descendants dominate the population of Oregonians. Sadly, not all of them recognize the benefits that health care insurance coverage can provide. Thanks to the breakthrough of the Oregon Health Insurance Experiment in 2008, health plans in Oregon have gained the recognition that they deserve. Low-income, uninsured adults were drawn through a lottery in the implementation of its Medicaid program’s limited expansion.

Selected participants are then listed to file a restricted number of available spots. Execution of this method aims to filter those who are eligible and not to apply for Medicaid. Moreover, the random selection paved the way for the results, with researchers discovering the many benefits of health care for the public. This collaborative study didn’t only bring successful research results to the researchers but also gained the federal government of the state of Oregon the advantage of public health insurance awareness.

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’s all the more reason to be helpful for the citizens of Oregon.

Benefits of Health Insurance Coverage

Results revealed that the provided Medicaid coverage bore witness to a significant increase in outpatient visits, hospitalizations, prescription medications, and emergency department visits. These findings suggest that people keep to themselves and endure a lot more than they can handle due to lack of benefits such as individual health insurance. Moreover, the coverage granted these recipients with lowered medical debt. It might as well have gotten rid of any nightmares of a tragic medical bill.

As if those changes weren’t enough, the insurance coverage also moderated depression frequencies. It may not have any statistically recorded effects on other conditions such as blood pressure, cholesterol or cardiovascular risk, but such advancement is already considerable progress in itself. Nonetheless, these findings are not the only things that insured plans reward their beneficiaries. Here is a list of what you can get when you sign up for health insurance.

Inpatient Care

Insured people who experience symptoms can be at ease in terms of financial worries. Should they need treatment in a hospital or any health care facility, they can seek inpatient care from a partner of their insurance provider and get the medical attention that they need.

Outpatient Care

Contrary to inpatient care, this variation allows the patient to not spend another good night’s sleep in the confines of a hospital. They have the freedom to leave the facility once the procedure intended for them is over. In other words, they don’t have to be under supervision unless there is any sort of serious complications. One advantage for this is that patients get to recover faster as they rest cozy in the comfort of their own homes rather than being confined in an uncomfortable, sanitary hospital room. Another is the fewer costs of outpatient procedures. Still, both inpatient and outpatient services are covered by your health insurance.

Laboratory Tests

People need routine checkup and laboratory tests more than they think. Having your blood, urine or body tissues examined regularly will help doctors diagnose medical conditions as early as possible. The results could also assist in the planning or evaluation of treatments and can monitor existent diseases as well. If you are insured, then you won’t have to worry about lab test costs.

Prescription Drug

There’s a higher tendency to consume drugs that are not prescribed for the people due to the main reason that getting prescription drugs requires more effort and a higher fee. Of course, you would have to go through a checkup before a doctor can recommend medications for you. However, if you equip yourself with health insurance coverage, you will have both your doctor visits and prescription drugs covered.

Preventive Services

This facet is where the check-ups and patient counseling comes in. Screenings that can prevent illnesses, diseases and other health-related problems are under this as well. Thankfully, the US Affordable Care Act required the majority of health plans to ensure clients with a set of preventive services without obliging them to copayment or coinsurance. It also allows you free from meeting your deductible just to be able to receive certain preventive services.

Recovery Services and Device

Whether you are injured or have a disability or any chronic condition, you can avail services and devices that can help you recover through insurance plans. Some of the inclusions are physical and occupational therapy, speech-language pathology and psychiatric rehabilitation.

Emergency Room Insurance

Accidents are inevitable. It can choose anyone, anywhere, anytime. The least that the people could do is to invest in health care rather than suffer from more expensive fees later. Moreover, the emergency room is among the most costly line item in an average American patient’s medical bill as it might include ambulance transportation, ER doctors, equipment tests, and medication.

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.

Care Before and After Giving Birth

Giving birth isn’t the only process by the end of pregnancy; there is a before and after and both require specific care. Mothers become hesitant in acquiring such services because, again, of financial matters. They would rather suffer at home than pay for such accommodations that they actually need. Good thing, it’s among the coverage of comprehensive insured plans.

Pediatric Services

Adults are not the only ones who call for medical interests; kids do, too. While getting an additional plan for your kids will mean another expense for you, you wouldn’t want it costing you more when something happens to them. You’ll never know what will come, so you might as well be prepared than sorry.

Health insurance plans are being stereotyped because people see it more of an additional expense than a valuable investment. While there are some who reject the concept entirely, consumers are immersing in the many proven benefits that they are getting. World Health Statistics demonstrate that “too many people are still dying of preventable diseases” and that “too many people are unable to get the health services that they need.”

Hence, it is imperative that health insurance is not just any expensive commodity; it’s 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 things such as health care. The Oregon Health Insurance Marketplace is the conviction that people seek in their objectives toward an Oregon health plan. They guarantee consumers that health insurance plans available on HealthCare.gov are compliant to state and federal requirements. With this, Oregonians get the assistance and assurance that they need in seeking health insurance that will not only work best for their budgets but for them as well.

Obtain Financial Assistance

This cost-sharing reduction gives people the allowance 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. Some areas even have at least 39 plans available as their choices. You can rest easy with the assurance that your insurance companies offer open enrollment for 2019.

Redeem Dental Plans

As part of the Marketplace coverage, clients could also benefit from their respective dental plans.

Special Options

Oregon is home to a rich variety of cultures and races, and it’s just right that these services be available for everyone. Private and public plans alike also cater to American Indians 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 is currently residing in Oregon have exclusive privileges as well. They can apply for the Compact of Free Association (COFA) Premium Assistance Program which can grant them free health insurance.

In The Oregon Insurance Marketplace, you can have assistance in getting covered, finding local help, coverage, and guidance even for those who are already covered.

Different Plan Options that you Can Choose From

Before aiming for a particular health plan, you must know that every single policy has its own distinctions. What may work for one might not take effect in the same way for others. Thus, you would also have to take note of the different plan options that you can choose from.

PPO

The Preferred Provider Organization plan is a group health insurance policy which encourages employees to avail themselves of a network of preferred doctors and hospitals. PPO could be the best option for your small business and your employees due to its flexibility, convenience and the balance of gaining a greater provider choice over lower premiums.

HMO

The Health Maintenance Organization Health Insurance Plan allows for a lower out-of-pocket expense for the employees. However, they would have less lithe in choosing physicians or hospitals than the other plans. Likewise, HMO provides a broader range of coverage in terms of preventive services compared to other policies.

POS

The Point of Service Health insurance policy is a combination of the features of HMO and PPO. This option would work best for employees who need variations in physicians and other providers, who want primary care physicians or seeks the balance of greater provider choice over lower premiums.

EPOs

The Exclusive Provider Organization Health Insurance plan is similar to that of HMO in a way that they employ an exclusive network of physicians whom their members are only required to use. An emergency is the only exception for this one. Moreover, the members are the one responsible for small co-payments. There could also be instances that may require deductibles.

Indemnity Health Insurance

This type is best known for its being a fee-for-service plan. Pre-determined amounts or percentages of costs are paid to the member for their covered services. On the other hand, the member may be held responsible for deductibles and co-insurance amounts. Some members opt to pay first using their own money and then file reimbursements for the covered amount.

HSA

The Health Savings Account Health Insurance plan is another alternative to traditional group health insurance. This health savings account is tax-favored and can be attached to group health insurance. Owners of this type are employees to which small businesses can contribute whether they offer a group policy or not.

QSEHRAs

The Qualified Small Employer Health Reimbursement Arrangements is a health insurance benefit suitably designed for small businesses with an employee count of lower than 50. This option provides employees their monthly allowance of tax-free money which members can then choose and pay for the health care services 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 an option that is perfect for your qualifications and needs. What’s important is that you recognize the benefits that a comprehensive health insurance policy can grant you. Once you experience firsthand what this valuable commodity can do, you will know for sure that you are getting your money’s worth.