Election : State Health Care Snapshots
Health care is a top issue for voters in the 2020 election. Polling indicates voter concerns range from the high cost of health coverage and prescription drugs, to protections for people with pre-existing conditions, to womens health issues.
To understand the health care landscape in which the 2020 election policy debates will unfold, these state health care snapshots provide data across a variety of health policy subjects, including health care costs, health coverageMedicaid, Medicare, private insuranceand the uninsured, womens health, health status, and access to care. They also describe each states political environment.
Please note, the data included in these snapshots come from a variety of different sources and time periods, and therefore, may not be comparable.
Hospital & Doctor Insurance
Health ProtectorGuard fixed indemnity insurance,3 underwritten by Golden Rule Insurance Company, can supplement your major medical plan by paying cash for eligible, covered medical services, like a doctor visit, a trip to urgent care or a surgical procedure.
- No deductibles or copays to pay first
- Benefits paid regardless of other insurance
- Money to pay costs not covered by major medical plans, like a deductible
What Do Montanas Special State Programs Cover
The Healthy Montana Kids program provides health services for children under 19 in low-income households. Health services include physician visits and examinations, dental care, and eyeglasses. Services must be considered medically necessary.
Montana has additional low-cost or free health programs. These include AIDS drug assistance, services for special needs children, early intervention for developmentally delayed children, and provision of specialized aids to assist disabled persons.
Tammy Burns is an experienced health insurance advisor. She earned her nursing degree in 1990 from Jacksonville State University, obtained her insurance billing and coding certification in 1995, and holds a health and life insurance license in Alabama, Georgia, Iowa, Mississippi, and Tennessee. Burns is Affordable Care Act -certified for health insurance and other ancillary, life, and annuity products. She maintains an active nursing license and practices private-duty nursing.
Seeing firsthand how unsuspecting patients are frequently confused by an overly complex system they dont understand led Burns to become an insurance agent and health care consultant, now helping people understand the medical system. Since becoming an insurance agent in 2013, she has worked with some of the largest and most reputable insurance carriers and agencies in the nation, and she has built a large and loyal clientele by way of her commitment to transparency and personalized service.
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The Effect Of Insurance Deductibles On The Cost Of Health Care
MS residents insured through group, individual and medicare health plans generally have a deductible. Deductibles define the amount of the medical expenses the insured person must pay before the insurers coverage begins to pay the medical bills. The deductible amount depends on the insurance plan. Generally speaking, individual insurance has larger deductibles than other plans. Deductibles have the effect of increasing the cost of the insurance for people that file insurance claims. For example, a person on an individual plan paying the average price of $4,064 with a relatively common $6,000 deductible has an effective price of more than $10,000, if they use their insurance.
Public Health In Mississippi
Health factors in any community can impact what you pay for coverage. It is always important for you to have coverage that meets all of your goals, but some factors that may impact cost include the following.
Obesity in Mississippi
Adults who are overweight are more likely to suffer from serious health risks including heart disease, lung health complications, diabetes, and strokes. In this state, 37.3 percent of adults are considered overweight as of 2017.
Diabetes in Mississippi
Diabetes is difficult to manage and can be a life-threatening condition. In Mississippi, about 14.2 percent of adults had diabetes in 2017. This can increase health insurance costs due to medication and medical needs.
Childhood Obesity in Mississippi
Fit children are healthier and less likely to develop health complications such as high blood pressure and diabetes at a young age. In Mississippi, 37 percent of children between the ages of 10 and 17 are considered overweight.
< twitter> In Mississippi, 37 percent of children between the ages of 10 and 17 are considered overweight.< /twitter>
Mississippi Mental Health Statistics
Mental health is an important factor for overall health. Your health insurance will cover these risks. In the state, 12.8 people per 100,000 people committed suicide in the state. And, about 6 in every 100,000 people in 2016 died due to alcohol use.
Mississippi STD Statistics
What If You Need Extra Coverage
You may be concerned about how to pay for out-of-pocket expenses, such as your plan deductible, in the event you need healthcare. Supplemental health insurance can help.
Supplemental plans pay lump-sum benefits when you are diagnosed with a covered critical illness or have an accident resulting in covered medical expenses. You can use these benefits to pay for out-of-pocket expenses such as:
- Your short-term or major medical plans deductible and coinsurance.
- Medical bills not covered by your short-term or major medical plan.
- Living expenses such as rent or mortgage, childcare and car payments.
Like short-term plans, supplemental plans may include extra non-insurance benefits such as telemedicine consultations, prescription drug discounts, and vision care discounts.
The cost of supplemental health insurance varies based on factors such as where you live and the level of benefits you select. Below are two sample quotes based on the earlier example of a 28-year-old woman living in Rankin County :
You can buy supplemental insurance through a private marketplace website, a licensed health insurance agent or broker, or an insurance company.
As you shop for health insurance and compare your options, look beyond premiums and deductibles. Read plan details carefully, and note what is included as well as excluded to be sure the coverage fits your needs. If you have questions about a plan, contact the insurers customer service department and ask before you enroll.
Insurance For Families In Montana
If you need coverage for multiple people, you need to think about how each person might use the plan. A spouse may need maternity care or fertility services, while a child might need to be covered for a tonsillectomy or other common childhood procedure. Review plan details carefully to make sure the services you need are covered. If someone in your family receives specialty care, you should also check to make sure the specialist participates in the plans network.
Another consideration for family plans is that many plans have an individual deductible and a family deductible. An individual deductible applies to each person covered by the plan, while the family deductible applies to the entire family. If one of your family members is hospitalized or undergoes an expensive surgery, its possible to meet the family deductible before every person on the plan has met their individual deductible.
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What Factors Influence The Cost Of Mississippi Individual Health Insurance
Under the new health care law, insurance companies are only allowed to consider five factors when determining rates: for Mississippi residents, your location, age, tobacco use, plan type, and whether the policy covers dependents.
Where You Live – Yes, health insurance premiums vary from one state to the next and even neighborhood to neighborhood. The cost of living and the typical wage are two elements that influence how much you will pay for a health plan.
Your Age – Your age will impact your premiums, just like most insurance. When you get health insurance, the younger you are, the lower your rates will be.
Tobacco Use – The use of tobacco is very likely the one thing on this list that will cause you to pay more for insurance. Regarding health insurance, premiums can rise by upwards of 60% per month.
Individual vs. Family enrollment – Plan Category – Bronze, Silver, Gold, Platinum, and Catastrophicthe essential health benefits have to be the same in all Marketplace health plans
Frequency Of Using Medical Services Other Than A Doctor Or Hospital
Non-doctor health care visits is a measure of how often people receive medical care without seeing a doctor. This type of care excludes patients that have been admitted to hospitals or other institutions. Examples of non-physician health care includes appointments or walk-in clinics to see a nurse, physical therapist, counselor for mental health appointments or other non-physician medical personnel.
The frequency of use for non-physician care in Mississippi is high, for all types of patients. Non-physician care tends to be an expensive form of treatment. The reason non-physician visits are expensive is that many times these are visits to outpatient facilities. Most outpatient facilities are owned and operated by hospitals. While hospital owned and operated medical facilities are less expensive than a hospital, oftentimes they are more expensive than a doctor visit.
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What Is The Average Health Insurance Premium By State
According to an annual study by KFF, monthly average premiums for an individual buying health insurance through the federal or a state exchange are as follows:
National average: $438
KFF states that these monthly averages are based on the second-lowest-cost silver-tier premium for a 40-year-old.
As you can see, where you live makes a difference in what you pay for health insurance. Much of the variance is based on each state’s insurance and healthcare marketplace. Factors such as the number of competing insurers, whether a state has expanded its Medicaid program, and the degree to which hospitals have consolidated within a state all play a role in insurance premiums.
Some Companies Less Inclined To Help With Insurance Costs
Mitchell Adcock, executive director of the Center for Mississippi Health Policy, said a state’s employment situation plays a key role in how much companies are willing to pay for their employees’ insurance. If it’s difficult for a company to find new employees, that company will be more inclined to pick up more of the cost, to keep their current workers around.
“The most difficult state for an employee and their family would be a state where wages are low, and employers don’t feel pressure, or are not inclined to be generous in their sharing of health care costs,” said David Blumenthal, president of the Commonwealth Fund. “So the nature of the market for workers is a very important factor in this equation. You don’t want to be in a low-wage environment where there’s an abundance of workers.”
Mississippi Commissioner of Insurance Mike Chaney said most of the cost hikes aren’t because of insurance companies. “The problem is the health care providers the hospitals and the providers, and the pharmaceutical companies” that are charging increasingly more for their services, he said. Chaney said he can only reign in insurance company prices so much, “and they’re already some restrictive procedures” from the federal government.
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Mississippi Small Business Resources*
Mississippi Health Insurance Coverage:
Group Plans: There is a maximum 6-month look-back/12-month exclusionary period for pre-existing conditions on enrollees that do not have prior coverage. Benefits will vary depending on the chosen plan. Pre-existing health conditions covered.
Individual Plans: Assorted plans depending on medical needs. There is a maximum look-back period of 60 months and a maximum exclusion period of 24 months for pre-existing conditions on enrollees that do not have prior coverage. Elimination riders are permitted. Limits on pre-existing health conditions may apply.
COBRA: Coverage available for 18-36 months depending on qualifying events. Benefits are what you had with your previous employer. Pre-existing health conditions covered.
HIPAA: Benefits are based on program selected. There is no expiration of coverage. Pre-existing health conditions covered.
HIPAA: Premium assistance that pays employer-sponsored health insurance or Cobra premium available. Pre existing health conditions covered.
Mississippi Health Insurance Eligibility:
Group Plans: Guaranteed coverage for companies with 2-50 employees. Eligible employees must work at least 30 hours a week. Owner can count as an employee. Owner name on business license must draw wages from the company.
Individual Plans: Eligibility is subject to medical underwriting. If you are denied coverage for a medical condition, you may be eligible for AHIP, or PCIP.
Mississippi Health Insurance Monthly Cost:
What To Know About Insurance In Montana
- Individual health insurance plans are available to individuals, families, and self-employed people with no employees. You can buy individual health insurance as long as youre a legal Montana resident.
- Open enrollment: Open enrollment dates in Montana are through November until January 15 each year. New health plans can be signed up for or amendments to existing plans made during this period.
- Special enrollment: Outside of the open enrollment period, special enrollments are available when you experience milestone life events such as moving to a new address, marriage, or having a baby are eligible for Special Enrollment Periods. You have 60 days from the actual event to make health insurance changes.
- Health Insurance Marketplace: Montana does not have a state exchange and uses the federal exchange. Individual health insurance plans in Montana can be bought through Healthcare.gov. During the open enrollment period for 2021 coverage, 44,711 people enrolled in individual/family plans through Montanas exchange. All Affordable Care Act health plans guarantee coverage for defined essential benefits.
- Coverage types: According to 2019 insurance data, Montana employers covered 43% of insured residents. Federal and state funded programs Medicaid and Medicare-had enrollees of 20.8% and 18.1%. Non-group insured made up 8%, while the military only covered 1.8%. Uninsured Montanans were at 8.3%.
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Commercial Truck Insurance In Houston Tx
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What Types Of Alternative Health Insurance Plans Are Available In Mississippi
The most popular form of cost-sharing plans are faith-based plans. In a faith-based plan, members share health care costs with other members. You dont need to be a member of a particular denomination , to participate in a plan. While these plans can be relatively low-cost, most faith-based plans dont conform to Affordable Care Act standards and dont cover pre-existing conditions, mental health care, or pregnancy.
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What Else Affects My Costs
Networks are made up of doctors and hospitals that insurance companies have agreements with about how much they will charge you. You can usually use an in-network or out-of-network provider, but the out-of-network visit will likely cost you more. Find out if a doctor or facility you want to go to is in or out of your network.
Out-of-network providers might also charge more for a service than the allowable amount. Allowable is the maximum amount your insurance company will pay for a particular service. You would have to pay the amount charged over what was allowable.
Policies include out-of-pocket limits, which determine how much, at most, you or your family would have to pay each year. Your monthly premiumsand possibly some other costsare not included. Check your plan instructions to see what is included in the out-of-pocket costs.
Information Sheet 1992
How Much Is Health Insurance Per Month For One Person
Monthly premiums for Affordable Care Act Marketplace plans vary by state and can be reduced by subsidies. The average national monthly health insurance cost for one person on an Affordable Care Act plan without subsidies in 2022 is $438.1
Wondering how insurance premiums are decided? The Affordable Care Act ensures that insurance companies cannot discriminate based on gender, current health status, or medical history. Here are factors that determine health insurance premiums.
How Much Does Health Insurance Cost In Montana
The cost of health insurance plans in Montana dropped quite dramatically in 2020 by roughly 13%. Lower premiums were due to reinsurance legislation coming into effect that year. Reinsurance helped keep average monthly premiums down in 2021 as well.
Montanas Health Insurance Marketplace uses a metal tier system for their plans: Bronze, Silver, Gold, and Platinum. For cheap health insurance seekers, the Bronze level is the least expensive and the most costly is Platinum. However, the higher the monthly premium, the lower your out-of-pocket costs could be.
Tax credits can help lower the cost of monthly premiums across all metal tier plans, but you must buy your health plans via Healthcare.gov to qualify. In 2021, the American Rescue Plan provides subsidies if health plan costs are more than 8.5% of your household income.
|Average premiums in Montana|
Mississippi Health Insurance Laws
The Affordable Care Act mandates what insurance companies cannot consider while pricing your policy.
- Pre-existing conditions: The ACA prevents insurance companies from charging you more for a pre-existing condition. Providers used to charge steep premiums for people with pre-existing conditions if they could even get coverage.
- Gender: According to a study regarding lifetime health care costs, women historically pay more for health care. However, the ACA doesnt allow providers to charge women and men different prices for the same plan.
- Insurance and medical history: Insurance companies also used to charge more for lapses in insurance or previous medical problems. Now, the ACA limits companies from doing that.
Theres a limit to how much youll pay out-of-pocket for a marketplace plan. In 2020, the out-of-pocket maximum is $8,150 for an individual plan and $16,300 for a family plan.
MS law requires health insurance companies to offer at least some coverage for the following services:
- Mental illness
- Dental anesthesia
- Child immunizations
There are additional services that health care companies need to provide. Check cms.gov for the full list.
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