by Chetna Chandrakala,
CFO, Oak Orchard Health
Health is wealth that you gain by caring for yourself and your physical, mental, and emotional well-being. Good health gives you quality of life – you live longer and enjoy life more. Being proactive about your health can help you prevent illness and disease.
Do I need Health Insurance?
Health insurance makes healthcare affordable, it allows you to see your healthcare providers when needed, from yearly physicals to sick visits, dental exams, and vaccinations.
One way to be insured is through your employer. According to the Affordable Care Act, large employers must provide health insurance coverage to 95% of their full-time employees. Employers with fewer than 50 employees are exempt from the employer mandate.
If your employer does not offer health insurance or you are unemployed, you may have to look at alternative insurance options. Depending on income, age, employment status, and health issues, people may be eligible for government programs that help pay for medical care. These programs include Medicaid, the Children’s Health Insurance Program (CHIP), Medicare, and the Affordable Care Act (ACA).
When children turn 26 and are no longer covered under their parents’ insurance, it is easy to continue without coverage and not seek preventive care. However, without health insurance, you’re at a much greater risk of gathering medical bills that you may be unable to pay.
What is the New York State of Health?
The New York State of Health is the official health plan marketplace for New York State. It allows individuals, families, and small businesses to shop for, compare, and enroll in health insurance plans. The marketplace offers a variety of plans and is a place where you can get financial assistance to lower the cost of your health coverage. https://nystateofhealth.ny.gov/
Oak Orchard helps make getting insurance easier
Applying for health insurance can often be difficult. At OOH, we have representatives from health insurance companies such as Fidelis, Excellus, United Health etc. in our health centers to help with this process.
How else can Oak Orchard help?
Oak Orchard Health (OOH) is a Federally Qualified Health Center (FQHC) that is required to provide affordable care to all patients, regardless of their ability to pay. FQHCs are nonprofit organizations that serve medically underserved populations and areas. They offer a variety of services, including primary care, dental and mental health care, and substance abuse treatment.
Here are some ways FQHCs provide affordable care:
•Sliding fee scale: FQHCs use an income-based sliding fee scale for patients without insurance or for patients with high deductibles or co-pays.
•No patient turned away: FQHCs never refuse care for patients because they can’t pay.
•Culturally sensitive care: FQHCs provide care that is non-discriminatory and culturally sensitive.
•Accessible care: FQHCs provide appointments when patients need them and offer after-hours care.
The Sliding Fee Discount Program
As an FQHC, OOH provides a sliding fee scale for services based on the federal poverty guidelines (FPG). All OOH patients will be assessed for sliding fee discount eligibility based solely on income and family size. The Sliding Fee Discount Schedule (SFDS) shall apply to patients with income levels up to and including 200% of the federal poverty income level (for an individual that amount would be $30,120). Patients with incomes at or below 100% of the federal poverty guidelines will pay a nominal charge. The nominal charge is a fixed fee for services that do not reflect the actual value of the service(s) provided and is considered nominal from the patient’s perspective. SFDS applies to patients without health insurance or if they do not have enough coverage and provides a graduated discount for patients with incomes between 100% and 200% of FPG. If you have questions about this program, please call our billing office at 585-637-3905 or visit our website at https://bit.ly/3Zp50DG
So why is it better to have Health Insurance Coverage?
Data shows that every dollar spent on vaccinations saves $5.30 on healthcare costs. If we carefully choose our insurance and pay upfront to secure our healthcare coverage, we will not only be healthier but also avoid high healthcare expenses, accumulating medical bill debt, or even bankruptcy.
