扩大选择背后的健康公平

朱莉·埃斯特利克

When Javier González (not his real name) started having headaches and other unexplained symptoms, 他很担心. 在他意识到之前, the healthy 32-year-old could no longer work out several times a week and had to quit a job that required a lot of physical labor. With no health insurance and his savings drained from multiple doctors’ visits and tests, González搬回父母家了.

他的最终诊断是:恶性脑瘤. 手术, 辐射, 然后是化疗, 这些加起来估计要700美元,000, 据CostHelper网站报道.com.

幸运的是, González找到了拉里默健康连接, a free program of the 十大娱乐彩票平台 that helps residents understand how health insurance works and review coverage options to make the best choice for them and their families. The 拉里默健康连接 team offers Question and Answer sessions and special enrollment events during Open Enrollment which begins on 11月. 1.

拉里默健康连接 Certified Health Coverage Specialist Roy Ramirez determined that González qualified for Health First Colorado, Colorado’s Medicaid Program (free or low-cost health care for children and adults who qualify) and helped him get enrolled. It was one less thing for the young man to worry about as he faced the battle of his life.

“那是一段压力很大、改变人生的时期. I’d never experienced health complications and suddenly I had a serious diagnosis,” González says. “我非常感谢罗伊和拉里默健康连接. Medicaid coverage has allowed me and my parents to focus on my treatments and regaining my health.”

在这个变化的经济时代, Cherie Nelson Senie and her partner Evan Nelson Senie were ready to make a bold career change and came to 拉里默健康连接 to figure out their insurance options. “我们想辞掉工作，开始做文案生意, 但阻碍我们前进的是失去医疗保险,尼尔森说. “It was scary, but Roy was so patient and made the information simple to understand. 我们都找到了适合我们的保险计划——这确实验证了我们的决定.”

Ramirez and the rest of the 拉里默健康连接 team are gearing up for a busy fall as Open Enrollment for 2023 kicks off on 11月. 1. Open Enrollment (OE) is the time when everyone can elect or change their health insurance plan for the next calendar year through the 连接健康科罗拉多州 Marketplace. 在科罗拉多州，OE期持续到1月6日. 15, 2023. 但是，您必须在12月6日星期二之前注册. 为了在2022年1月15日开始覆盖. 1, 2023. 在那之后，保险从2月6日开始. 1. 去年, 拉里默健康连接帮助931名拉里默县居民找到了保险, and staff expects increased demand this year due to a new insurance shopping platform the state is rolling out. The new Colorado Connect has plans that offer more cost savings to people who haven’t qualified in the past, 包括对无证件个人的选择.

Selecting and purchasing a plan through the marketplace can be confusing and overwhelming. 拉里默健康连接 staff help clients understand their options and any financial assistance that can lower the cost of health insurance. They also assist in completing the application process for coverage through the marketplace, or enrollment in Medicaid or Child Health Plan Plus (CHP+) for those who qualify.

扩大公平覆盖面

2023年新功能, people who didn’t previously qualify for health plans and savings on the marketplace may be able to find options on Colorado Connect. 设计时考虑到健康公平, 计划包括对消费者免费的高价值服务, 并首次为无证科罗拉多人提供保险选择. Coloradans without documentation who meet income qualifications can also receive financial help for certain plans.

“有史以来第一次, 无证家庭和个人可以享受0美元的保费,罗西·杜兰说, 拉里默健康连接的项目协调员. Those who don’t meet the income criteria can still purchase full-priced plans on Colorado Connect.

Colorado Connect offers standardized state plans with the same essential health benefits and cost-sharing among all insurance carriers. 计划福利包括心理健康服务, 初级护理, 产前和产后护理, non-preventive访问, 和更多的.

“标准化计划将有相同的共付额, 免赔额, and out-of-pocket maximum costs across all insurers so it’s easier for consumers to compare plan benefits and know how much they’ll pay for their most common services,杜兰说. 这些计划的保费和供应商网络会有所不同.

安心

如果这一切让你头晕, never fear: “拉里默健康连接 can help people figure out what they are eligible for and how best to enroll,杜兰说. 事实上, 如果你在Colorado Connect购物的话, state leaders encourage finding assistance this first year rather than doing it yourself to help ensure a seamless process. (见接线盒.)

No matter your circumstances, the key is not to skip coverage for any family member. 人们很容易低估自己的医疗费用. 例如, 科罗拉多州健康连接组织估计，一条腿骨折可能高达7美元,如果你没有保险，500美元. 如果没有保险，生孩子可能要花费1万美元.

“Health insurance can help you stay healthy by covering the costs of many health benefits and protect you from debt,她说。. “If your child gets sick and needs to see a doctor or take prescription medications, 它可以支付部分费用. 如果你被诊断患有慢性疾病, 如糖尿病, 保险范围可以帮助你免受高额损失, 意想不到的费用.”

González当然可以理解.

“你永远不会想到你每年都会达到免赔额, but with a brain tumor I would have met my out-of-pocket limit at the first cancer appointment. 如果我能回去工作的话, I’ll make it a priority to find a job with health insurance coverage or purchase my own for sure.”

拉米雷斯和他的团队成员随时准备在OE期间提供帮助, 对于那些最近发生了生活事件的人来说，全年都是如此, 比如失去其他保险, 移动, 结婚, 或者生孩子.

“Right now there are so many options for Coloradans at different income levels to qualify for financial assistance, 尽量减少医疗费用责任, 选择一个符合他们需求和预算的健康计划,拉米雷斯说. “没有人打算生病或发生事故，但生活就是这样. 健康保险可以让你在意外发生时安心.”