Understanding your Health Insurance: Health experts say they are here to help

Understanding your Health Insurance: Health experts say they are here to help

HATTIESBURG, MS (WDAM) - Hospitals, doctors, to marketplace exchanges and private insurance companies. They are all connected, and they affect you, your health and your wallet.

Mississippi Commissioner of Insurance Mike Chaney knows this better than most. It’s his job to know health insurance inside and out. But he said healthcare can be intimidating for the consumer.

“So we tell them if you need help, just call us on the phone it’s OK ,” Chaney said.

He said next year’s health insurance outlook shouldn’t be daunting for folks with rates lowering 4.5 percent.

“We’ve had some decreases in individual and group rates throughout the state, from the major carriers being Blue Cross Blue Shield and United Healthcare in the state,” Chaney said.

And he said Ambetter Health Insurance Company will carry the Affordable Care Act next year.

“Their rates will actually go down a little bit this year,” Chaney said.

With Mississippi having a high employment rate, that means uninsured rates are down, according to Chaney. But that’s not the case for everyone.

“We have about 300,000 plus or minus 20,000, either way, at any given time that are uninsured in the state,” Chaney said.

So Chaney worries. He said the uninsured create a domino effect that tumbles to rural hospitals, health insurance companies and in worst case scenarios your access to quality health care.

“We have had four bankruptcies within the last two months of our rural hospitals,” Chaney said.

Chaney said if someone with no insurance or Medicaid walks in to a hospital they have to be treated. He said that’s a federal and state rule that leaves hospitals to take the financial hit.

“As an example, the Greenwood Leflore Hospital, which you would think would be very prosperous, lost $1.7 million in the month of July," Chaney said. “And that’s in addition to 11 previous months with losses of over $1 million each month.”

And that impacts Mississippi consumers. When the loss is too great, hospitals close. Chaney’s department reported it has happened to five rural hospitals in Mississippi since 2010. Those hospitals are: Quitman County Hospital, Pioneer Community Hospital of Newton, Merit Health Natchez- Community Campus, Kilmichael Hospital and Patient’s Choice Medical Center of Humphreys County.

Chaney said if health insurance companies don’t have access to providers, then customers don’t have local coverage. So if the worst happens to Greenwood Leflore Hospital, residents there would have to travel 40 minutes to an hour to find care elsewhere. This isn’t Chaney’s only concern that impacts Mississippians healthcare.

“The cost of drugs or prescription drugs in the state, they tend to go up,” Chaney said.

The price of prescription drugs have tripled and quadrupled in Mississippi, costs that are solely controlled by the pharmacy association and benefit managers, according to Chaney.

“Prescription drugs constitute 30 to 32 percent of the rates that consumers have to pay on a monthly basis for health insurance,” Chaney said.

He said to even begin to know what insurance plan is best for you, you have to know the cost of your medicines. Beginning on January 1, 2019, Chaney said he’s going to help you do that by posting companies' drug formulas on his department’s website.

“They can go to our website and say,'Hey, these drugs are not covered under my policy, I want to know why.' Or, ‘they are covered and I’m paying too much for them,'” Chaney said.

Without guidance like that, consumers can run into pit falls trying to find a health plan, and that’s where the state and nonprofits like Health Help Mississippi step in.

“We see consumers who are having to make a choice: Is it either buy my groceries or buy my prescription drugs” said Keri Abernathy, senior program manager with Health Help Mississippi.

Abernathy said they help the insured, uninsured and under-insured find healthcare options they can manage.

“We have a free screening process where we will ask some questions of the consumer, their family makeup, what does it look like and hopefully guide them into a reasonable option,” Abernathy said.

Abernathy said Health Help can provide a consumer guide to knowing your rates, know what you’re being charged and finding hidden costs.

“Going in to that, really understanding what your plan means for you, it really helps a consumer on the back end really lower any out of pocket expense that they have,” Abernathy said.

Abernathy said they’re here to make sure that expense doesn’t turn into a liability. She said 52 percent of consumer debt in the U.S. is medical debt.

“Mississippi has the highest rate of medical debt in the United States,” Abernathy said.

And Chaney and Abernathy agree, seeking or having health insurance shouldn’t feel like a burden when there are resources, like them, out there to help you.

If you have questions about health insurance in Mississippi, or you want more information on the prescription costs soon to be posted on the Mississippi Insurance Department website, Chaney said feel free to call at 1-800-562-2957 or go to www.mid.ms.gov.

And for help with understanding your plan, guidance finding insurance or even insurance billing appeals Abernathy said contact Health Help Mississippi at 1-877-314-3843 or go to www.healthhelpms.org.

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