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Network adequacy takes the stage

panelDuring the 2015 Legislative Session, the State Senate established the Consumer and Provider Protection Act Study Committee. This committee will review and make recommendations around several health insurance practices, including network adequacy. GHF has identified network adequacy, or the sufficiency of the health care providers patients can access when they enroll in a health insurance plan, as an important emerging consumer health issue. Our Executive Director, Cindy Zeldin, is a member of the study committee and looks forward to bringing the consumer perspective to the committee’s work. Cindy also recently appeared on WABE and Top Docs Radio to talk about network adequacy and participated in a panel discussion along with several state legislators at the Medical Association of Georgia’s Summer Legislative Education Seminar to discuss this important issue. Stay tuned for study committee agendas, updates, and opportunities to weigh in!

 

Study Committee Schedule:

 

September 14, 9:00 – 12:00

State Capitol, Room 450

 

October 26, 2:00 – 5:00

Tift Regional Healthy System, Tifton

 

November 9, 9:00 – 12:00

State Capitol

 

 


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Health insurance literacy

From choosing a plan to using your plan, health insurance can be complicated and many Georgians lack the information they need to make informed decisions.  In GHF’s recent report Getting Georgia Covered: Best Practices Lessons Learned and Policy Recommendations from the Second Enrollment Period, we interviewed enrollment assisters across the state and found that more than two-thirds of our survey respondents identified low health insurance literacy as a barrier to enrollment. Many of the consumers that assisters worked with had never been insured before, so they did not know how to choose a primary care physician or pay their monthly premium. One of the assisters interviewed acknowledged they needed to educate consumers on how to use their health insurance, but that it was a challenge when scheduled with a large number of enrollment appointments, although there are lawyers and Massachusetts firms that are specialized in insurances policies so they can help you understand better how it works. Additionally, some assisters reported that consumers chose the lowest premium plan because they did not understand the concept of a high deductible. Sometimes consumers would return to the assister wanting to change plans once they had tried to use their coverage. As we move forward, Georgians for a Healthy Future will be focusing efforts on improving the health literacy of Georgians and ensuring they have the knowledge, information, and confidence they need to make informed decisions.

 


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OE2 by the numbers

New health insurance opportunities created through the Affordable Care Act (ACA) have let to historic reductions in the nation’s uninsured rate.  The strong enrollment numbers in Georgia mean that more Georgia consumers can access the health care services they need and enjoy enhanced financial security for themselves and their families.

Georgia OE2 by the Numbers


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New resource! Getting Georgia Covered: Best Practices, Lessons Learned and Policy Recommendations from the Second Open Enrollment Period

GHF_enrollment_stickerNew health insurance opportunities created through the Affordable Care Act (ACA ) have led to historic reductions in the nation’s uninsured rate. Here in Georgia, more than half a million consumers signed up for health insurance during the open enrollment period that ended this past February, known as OE 2.

 

These strong enrollment numbers mean that more Georgia consumers can access the health care services they need and enjoy enhanced financial security for themselves and their families. The reduction in our state’s uninsured rate, although smaller than that of the nation as a whole, also has positive implications for the vitality of local health care systems and communities throughout Georgia.

 

Too many Georgians, however, remain uninsured, either because

 

  • they are unaware that there are coverage options that can meet their needs and budget
  • face cultural, linguistic, financial, or other barriers to coverage; or
  • fall into the “coverage gap” that was created when Georgia declined to expand Medicaid as authorized under the ACA

 

The goals of this report are

 

  • to explain the role of in-person assistance on enrollment outcomes and consumers’ experiences
  • to explore best practices that helped achieve robust enrollment in Georgia
  • to identify any common challenges or barriers to enrollment that Georgia consumers faced during OE2
  • to highlight promising strategies and approaches to reach the remaining uninsured who qualify for affordable health insurance
  • to put forth policy recommendations that can help facilitate a positive experience for health care consumers, both for those who are newly enrolled and for those who remain uninsured.

 

You can download and read the report below.

[embeddoc url=”https://healthyfutprod.wpengine.com/wp-content/uploads/2015/12/Getting-Georgia-Covered-Cover.pdf”]


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2015 legislative session review: webinar

gold dome

 

 

 

 

 

 

 

 

 

 

 

 

 

How much of the state budget went to health, and where was that money allocated?

Which health care-related bills passed, and what do they mean for my family and my community?

For the bills that didn’t pass, are they dead?

What study committees should I be paying attention to throughout the summer and fall?

 

For a complete understanding of what happened this legislative session, don’t miss our webinar.  Lobbyist Andy Lord and Community Outreach Manager Laura Colbert will walk you through what you need to know and answer any questions you may have.

 

Don’t worry – you can still sign up!

 

Date:Thursday, April 9

Time:12:00 – 1:00 EDT


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GHF welcomes new navigator!

 

 

PranayPranaya Rana joined Georgians for a Healthy Future this week as our new Navigator! In this role, Pranaya will work with consumers to help them enroll in health insurance through the Marketplace.  Pranaya is a former Lieutenant from the Nepalese Army Elite Forces. He has served as a U.N. Peacekeeper in post-earthquake Haiti and as a Refugee Resettlement Program Officer in Connecticut before he came to Kennesaw State University, Georgia to pursue his Ph.D. in International Conflict Management in 2012.   He has been working as a certified Healthcare Navigator in Metro Atlanta since the first open enrollment began in 2013. He recently completed his 6 months long Navigator’s term at Georgia Watch before joining Georgians For a Healthy Future.  He specializes in refugees and international communities and has served a wide variety of international communities enroll into affordable healthcare using a community specific service model developed through continued outreach, education and  needs assessment. He is Fluent in Nepali and Hindi besides English, and, speaks Urdu and intermediate French. If you’d like to contact Pranaya, he can be reached by email or by phone at 404-567-5016.


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Tax-time special enrollment period

 

 

taxesDid you go without health insurance in 2014 and are now subject to a tax penalty? Good news! – You may still be able to enroll in coverage through the Health Insurance Marketplace. Starting last Saturday, March 15th, some people who are facing a fine on their taxes for not having coverage can now enroll in the Marketplace through a time-limited special enrollment period. To be eligible for this special enrollment period, you must not be currently enrolled in health insurance, attest that you owe the penalty for 2014, and attest that you first became aware of the penalty when you filed your 2014 taxes. This tax-related special enrollment period will run through April 30th, 2015.  Click here to learn more about who can qualify for this special enrollment period.


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Accessing preventive services: what consumers need to know

coverageDid you know that thanks to the Affordable Care Act, you can receive certain preventive services at absolutely no cost? It’s true! One of the key requirements of the ACA is that insurance companies must cover recommended preventive services at no cost to the consumer – even if you haven’t met your deductible. These include services such as mammograms, annual physicals, colonoscopies, well-woman exams, cholesterol screenings, tobacco cessation, and many more. Click here for a full list of the preventive services that must be covered by all insurance companies. There is also an additional list of required services for women and a separate one for children. It’s important to take advantage of these no-cost preventive services to keep you and your family healthy. Evidence shows that preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating them before they become complicated and debilitating conditions.

If you have any questions about your insurance, please contact our Consumer Education Specialist, Whitney Griggs by email or at 404-567-5016 x 5

 


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More good news on Georgia’s enrollment numbers!

Last month it was announced that over half a million Georgians enrolled in coverage through the Health Insurance Marketplace. Now a new report released by the Department of Health and Human Services contains even more encouraging data about the state of enrollment in Georgia. According to the report, 31% of Georgians that enrolled were between the ages of 18-34, which is a key age group since they tend to be healthier than older adults. Additionally, 90% of Georgians that selected a plan through the Marketplace received financial assistance in the form of Advanced Premium Tax Credits. The average monthly premium for Georgians using a tax credit was $73. Click here to see the full report.  Georgians for a Healthy Future’s ED talked with the Augusta Chronicle about why these numbers are so encouraging for Georgia.

 


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How to find a provider in your network

Recently enroll in health insurance for the first time and ready to see a doctor? When you do so, it is important to select health care providers that are in your insurance plan’s network of providers. You get the best deal when you use in-network providers, and your insurance plan may not pay at all for care from an out-of-network provider. To find the names of providers in your area who are in your insurance plan’s network you can:

  • Contact your insurance company by phone. The number is on the back of your card.
  • Look on your health insurance company’s website.
  • Call your provider’s office and ask them: 1. Do you take my insurance? 2. Are you in my plan’s network?

If you are having trouble finding accurate information about provider networks or are having trouble getting an appointment with an in-network provider, please let Whitney Griggs, our Consumer Education Specialist, know (Whitney can be reached at wgriggs@healthyfuturega.org or 404-567-5016). Whitney can walk you through the process and help you understand your rights and protections as a consumer.


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