GREAT FALLS — As the government shutdown continues, many Americans are left wondering how it will affect their health insurance coverage. The topic can be intimidating, with rising costs and convoluted policy terminology, but local experts are helping simplify it.
“My father started in the insurance industry in 1959. He founded Bern Insurance with a partner in 1996. Our family has been providing health insurance and answering complicated health insurance questions for 55 years,” said David Bern, president and co-owner of Bern Insurance in Great Falls.
Quentin Shores reports - watch the video:
According to Bern, the core of health insurance is risk pooling, which involves a broad number of individuals contributing to a pooled fund that covers the few who have major medical crises.
“If there's a city of 200,000 people and one of them is going to have a heart attack, and, you know, somebody going to have a heart attack, you don't know. So, everybody pays $1,000 a year to make sure that, the one guy that has a heart attack gets covered.”
This notion includes annual premiums and co-pays, which assist in covering the costs of routine care and medicines. However, those premiums are increasing more quickly than usual.
"If it's not risk pooling, then if everybody's doing it, then it's going to get baked into the premium. But this year it's 20, 25%."
According to Bern, inflation, workforce challenges, and rising pharmaceutical costs are among the many factors that have contributed to these increases. And other agencies claim the government shutdown has had no direct impact on their programs.
“It's not really affecting them. Very much. These plans are generally figured out a year or more in advance. And so, they're pretty much pre-set for the prices thing,” said Pam Roatch, Resource and Assessment Specialist.
“If individuals, seniors want to, call us to get assistance in figuring out Medicare and how it's how it gradually changes over the years, and want us to help them reexamine which plans they're on. We're here,” Kathy Briggs, Medicare Resource Counselor, remarked.
Meanwhile, open enrollment for the Affordable Care Act began on November 1st, and consumers should evaluate their income levels to avoid unexpected charges.
"If they wander over at that 400% threshold, they could be stuck with a really ugly surprise," Bern told reporters.
