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Making sense of health insurance
February 26, 2017

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The healthcare insurance industry is in a bit of a turmoil, as everyone knows who keeps up with the national news.

And, for us average Joes trying to figure it all out, well, it is darn near a full time job.

If you have insurance through a group plan at your work, a single individual insurance plan, or gotten insurance off MNsure, the Minnesota version of the Affordable Care Act (Obamacare as it is referred to), there is a lot to figure out.

There can be a dozen or more choices to make. Do I want the bronze, silver, gold or platinum plan? Do I want a high deductible and low premium or a low deductible and high premium? What things do I need coverage for? How am I going to afford all of this?

Even if you are an old person like me and you are on Medicare, it can still be confusing. What does Medicare cover? What kinds of Part A, Part B, Part C and Part D policies do I need?

And, for you younger folks out there, who might think Medicare is free, it isn't. You actually pre-pay for it while you are working at your job, and then you also pay for it after you get to be 65 years old. There is still a monthly premium for Medicare after you are old enough to get it. And then you also have to pay for the Medicare supplements which you might need.

Granted, I am not whining about this. My monthly premiums totaled together for Medicare are less than half of what I had been paying back with 'regular' health insurance. And, it covers a whole lot more.

But, still, it isn't free.

None of it is. Unless, of course, you are fortunate enough to work for a business or a government agency which offers to pay your full health insurance premium. Then, good for you.

Now, I don't claim to be an expert on healthcare insurance. Far from it.

And now, with Obamacare, I mean the Affordable Care Act, under fire and probably going to be dismantled or at least changed, it has become even more confusing to us average Joes.

And even to some Joes who are above average when it comes to healthcare issues.

Interviewing United Hospital District's Rick Ash two weeks ago for a story in our Medical Guide magazine included in this issue of the Faribault County Register, was enlightening and confusing at the same time.

While many of us struggle to understand our own multi-page health insurance policies and what it all means to us, Ash has to deal with the whole gamut of health insurance companies, policies, rules and regulations, and what it all means for UHD.

As the story in the Medical Guide reveals, Ash found out around the first of the year that UHD was being left out of the new MNsure network. And, he went to work trying to right that wrong, which he succeeded in doing.

Now, in the story, I tried to make it sound like David battling Goliath, the little guy against the big state government and the great big insurance companies, and that is sort of true.

There is, of course, more to it than that. The number of people who were being affected by this decision was relatively small. It was only those who had individual health insurance plans through MNsure.

Still, it is very important that people have a choice of where they want to go for their medical services. And when insurance companies dictate what is a network provider, it can limit a person's choice dramatically.

For instance, I live a block from UHD. I can walk there for a checkup, an illness, surgery or even physical therapy when I needed it. It doesn't make much sense to take half a day or more off from work and drive an hour to go to the doctor because my insurance company says so.

It also is important to have UHD be able to serve as many people as possible, in order to keep our local hospital and clinic open. And that means giving everyone the choice of going there if they wish.

I think it is incredible that we have such a wonderful facility like UHD in our local area. They now have four clinic locations (Blue Earth, Winnebago, Wells and Fairmont) and are soon going to be up to 17 health care providers (MDs, nurse practitioners, physicians assistants, etc.) on staff. They offer a full line of health care services.

That is remarkable.

Next up on the healthcare insurance horizon will be changes in Obamacare, and what it will mean for the average Joe with insurance through the Affordable Care Act and for hospitals like UHD.

Ash is already wondering what his next health insurance battle might have to be.

But, he is certainly ready to take it on.

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