Healthcare Access: How Can We Help?



What is Healthcare Disparity?

According to AHRQ (Agency for Healthcare Research and Quality) Healthcare disparities are differences in access to or availability of medical facilities and services and variation in rates of disease occurrence and disabilities between population groups defined by socioeconomic characteristics such as age, ethnicity, economic resources, or gender and populations identified geographically.

What are some issues around Healthcare Access?

Accessing healthcare in the united states could be faced with multiple different hurdles or obstacles. These barriers to accessing health care vary between populations, geographic locations, and societal classes. 

One of the largest barriers to accessing healthcare is not having health insurance coverage, or have a health insurance plan with a small network of providers. Thus it is imperative to not only have an  insurance plan, but to also make sure that the plan accepts the insured’s providers as in network.

According to U.S Department of Health and Human Services, about 1 in 10 people in the United States don’t have health insurance. People without insurance are less likely to have a primary care provider, and they may not be able to afford the health care services and medications they need. Strategies to increase insurance coverage rates are critical for making sure more people get important health care services, like preventive care and treatment for chronic illnesses. 

Other healthcare access issues, include poverty, illiteracy, language barriers, lack of knowledge or negligence of self care.

How Can Smart Insurance Agents Help?

Most Health insurance agents go through licensing exams and continuing education courses to maintain an acceptable level of healthcare understanding and keep up with the continuous changes. Our agents, Smart Insurance Agents, not only follow all the required training protocols by the Department of Insurance and insurance carriers, but also participate in workshops that further enrich solutions to health insurance barriers. Our health insurance agents work with our clients on problem solving rather basis rather than selling an insurance plan. We make sure our clients understand their rights, benefits, eligibility, and available options. In addition, we work with our clients on identifying a health care network of providers that is accepted by their plan to avoid the high out of network fees. 

We listen, we educate, we explain, and we advise. We are not just insurance agents. We are subject matter experts. We are educated about our industry, we understand the needs, hence we are capable to craft a unique solution to each client. 

In 2020-2021 during the unprecedented times with the COVID-19 pandemic, our health insurance agents worked remotely from home helping more clients than ever finding a health insurance plan that protected them and their families. When the American Rescue Plan was put into law, more individuals and families were eligible for subsidies or savings than ever. Our health insurance agents worked tirelessly to reach as many client as possible to make sure each and everyone of them received the savings they were eligible for. 

How to Choose a Health Insurance Plan with Good Healthcare Access?

Choosing the best health insurance plan requires 3 important criteria to be met:

  1. Network: It is important to choose a plan that accepts your providers and the hospitals you go to. Most plans may not pay for medical claims billed by out of network providers. In rare cases, the insurance plan may pay for a medical claim billed by a provider out of network but will cost the insured a lot of money due to higher deductible and higher out of pocket.
  2. Cost: Evidently the cost of the health plan (premiums per month) is important, nonetheless, the copays and coinsurance of the plan you pick are as important as well. If you use the health insurance plan for multiple doctors visits a month or anticipating some healthcare services like: Surgery, or other procedures, then you need to choose a health insurance plan with a lower deductible or lower copays. 
  3. Access to Providers and Drug Coverage: Always, always, always make sure to go over the plan in network healthcare systems and drug coverage if applicable. Since most health insurance plans on the marketplace are HMO (Health Maintenance Plan) then a referral may be required before seeing a specialist. Make sure all your specialists and/or the hospital systems are accepted by the plan’s network. If you take any prescription medication, particularly specialty medications that are usually very expensive, make sure that the plan covers the drug.

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