Top 10 most costly areas for ACA health insurance plans
Anyone buying health insurance inside a Colorado resort town may feel as if closing the laptop and schussing the slopes to ease frustration. These areas were just named the foremost expensive for medical coverage beneath the Affordable Care Act (ACA ).
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Kaiser Health News — which says its findings are depending on recent data coming from the Kaiser Family Foundation, the federal HealthCare. gov website and state exchanges — gives Colorado’s Eagle, Garfield and Pitkin counties (including Aspen and Vail ski getaways ) the very best premiums, at $483 a month.
Rural regions of Georgia, Mississippi and Nevada aren‘t far behind, as is really a Connecticut suburb of New York City, all Alaska and the majority of Wyoming. The premiums are driven by lowest price ” silver ” plan, and that is mid-level coverage that almost all consumers are buying with the exchanges.
Here will be the 10 most costly areas, depending on monthly premiums, consistent with Kaiser Health News :
$483 — Colorado mountain resorts (Eagle, Garfield and Pitkin counties). Also, premiums in Colorado’s Summit County are $462.
$461 — Southwest Georgia (Baker, Calhoun, Clay, Crisp, Dougherty, Lee, Mitchell, Randolph, Schley, Sumter, Terrell and Worth counties).
$456 — Rural Nevada (Esmeralda, Eureka, Humboldt, Lander, Lincoln, Elko, Mineral, Pershing, White Pine and Churchill counties).
$445 — Western Wisconsin (Pierce, Polk and St. Croix counties).
$423 — Southern Georgia (Ben Hill, Berrien, Brooks, Clinch, Colquitt, Cook, Decatur, Early, Echols, Grady, Irwin, Lanier, Lowndes, Miller, Seminole, Thomas, Tift and Turner counties).
$405 — Most of Wyoming, but excluding Natrona and Laramie counties.
$399 — Southeast Mississippi (George, Harrison, Jackson and Stone counties). Also, the lowest price plan in Hancock County is $447.
$395 — All of Vermont.
$383 — Southwest Connecticut (Fairfield County).
$381 — All of Alaska.
The Kaiser report says the lofty premiums in Colorado could be blamed on high costs for medical care in those areas. In other pricey regions, insurers can inquire about more income because there‘s a limited quantity of hospitals and specialists open to patients.
” High individual insurance rates also reflect the extra costs that come when locals are likely to have poor health and where large numbers of individuals lack employer-sponsored insurance, leaving providers with increased charity cases and lower-reimbursed Medicare patients, ” based on the report.
Health insurance options beyond the health insurance exchanges
The ACA requires the uninsured have coverage from the March 31 deadline or face a penalty. The fine in 2014 is $95 or 1 percent in an individual’s taxable income, whichever is higher. The penalty climbs to $325 in 2015 and $695 by 2016.
Subsidies can be found to assist shoulder costs for people who qualify. Consumers are eligible for any tax credit in the event that they earn as much as 400 percent from the federal poverty level — that is $94, 200 for any family of four in 2013. The tax credits aren‘t available for health insurance purchased outside the exchanges.
You are able to shop for insurance with the government-run exchange with your state, but additional options :
• Can you get it at work?
Most employer-sponsored plans meet minimum standards set from the feds ; your boss should have notified you of the by Oct. 1. Bear in mind, though, that almost all employer-based plans have open enrollment in the autumn. Your workplace can provide you with the specific details, including deadlines.
• Does an employer’s plan cover spouses or dependents?
Most work-based health plans extend benefits to spouses, albeit they are not legally needed to. Again, check along with your employer.
Also, anyone under 26 can remain on the parent’s medical plan, even if they should already get access to health insurance elsewhere, do not live with these or are married.
• Do you qualify for a government health insurance plan?
The ACA says you are covered when you have Medicare or Medicaid ; your children are covered in the event that they receive benefits beneath the Children’s Health Insurance Program.
Medicare is typically eligible to anyone 65 or older, possess a disability or end-stage renal disease. Have the ear of a seven-month period (starting three months before your 65th birthday ) to join Medicare in the government’s Medicare. gov site. In case you do not check in then, you are able to enroll from Jan. 1 to March 31 of each and every year.
Medicaid eligibility, which is expanded beneath the ACA, is founded on income and family size. Can you qualify? You are able to fill out a credit card applicatoin at the state’s health insurance exchange to see. You may also find out if your children could be covered with the Children’s Health Insurance Program.
• Go directly to a health insurer
Some companies that provide medical coverage — – including United Healthcare, Humana, Aetna, Cigna and Coventry — are not participating at many of the exchanges. But, in fact, they are still selling health insurance.
You will get relevant information by checking out their websites, speaking with their representatives or dealing with an insurance agent. These companies may provide a bigger sort of plans compared to the exchanges, which offer more standardized coverage.
Home » Uncategories » RS Putus Kerja Sama dengan BPJS Kesehatan Bukan karena Akreditasi Semata
RS Putus Kerja Sama dengan BPJS Kesehatan Bukan karena Akreditasi Semata
Direktur Utama BPJS Kesehatan Fachmi Idris mengungkapkan, putusnya kerja sama rumah sakit dengan BPJS Kesehatan bukan hanya karena akreditasi. Ada faktor lain yang memengaruhinya.
"Ada rumah sakit berakhir kerja sama dengan kami karena tidak memenuhi syarat kredensial. Jadi, tidak hanya soal akreditasi saja," jelas Fachmi dalam konferensi pers di Kementerian Kesehatan Jakarta, Senin, 7 Januari 2019.
Syarat kredensialing yakni uji kelayakan atas kriteria teknis yang meliputi sumber daya manusia (SDM), kelengkapan sarana dan prasarana, lingkup pelayanan, serta komitmen pelayanan.
Kriteria tersebut digunakan sebagai bahan penilaian dalam penetapan kerja sama dengan BPJS Kesehatan, jenis dan luas pelayanan yang dikontrak oleh BPJS, besaran kapitasi serta jumlah peserta yang dilayani oleh rumah sakit.
"Jangan sampai pasien tidak dilayani dengan baik," ujar Fachmi.
Rumah sakit yang bekerja sama dengan BPJS kesehatan diharapkan berkomitmen memberi pelayanan yang baik kepada pasien.
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