Health Insurance Terms You Need to Know (in the U.S.)

Transcript 00:00 let’s start with a breathing exercise 00:01 okay in through the nose and out through 00:05 the mouth 00:07 today we’re getting into a calm frame of 00:10 mind because we’re going to talk about 00:12 health insurance 00:15 [Music] 00:22 health insurance can be a super 00:24 confusing and frustrating thing to

Transcript

00:00
let’s start with a breathing exercise
00:01
okay in through the nose and out through
00:05
the mouth
00:07
today we’re getting into a calm frame of
00:10
mind because we’re going to talk about
00:12
health insurance
00:15
[Music]
00:22
health insurance can be a super
00:24
confusing and frustrating thing to deal
00:27
with but it’s a huge part of adulting
00:29
since we don’t have a crystal ball for
00:31
how the future of American healthcare
00:32
will turn out we won’t be talking today
00:35
about what kind of public or private
00:37
health care plan options might be
00:39
available to you instead this will be a
00:41
primer on the very basics of health
00:43
insurance for an individual regardless
00:45
of where your insurance is coming from
00:47
now what the next time you’re choosing a
00:48
plan or someone asks you how it works it
00:51
won’t all seem like some alien language
00:53
first up let’s talk about your insurance
00:55
policy that you’ll buy from your health
00:57
insurance company this is the plan that
00:59
says how much you’re paying and what
01:01
kind of services the insurance company
01:03
will pay for including routine checkups
01:06
and emergency care insurance policies
01:08
usually last for one year and you’ll
01:10
typically sign up for a new one around
01:12
December or January unless your
01:14
employment or life changes many health
01:17
insurance policies exclude dental and
01:19
vision coverage so you’ll need to buy an
01:22
additional policy to cover those things
01:24
if you have a eyes and teeth when
01:28
choosing your insurance policy it’s
01:30
really important to understand how much
01:32
you our premium will be the premium is
01:35
how much you pay each month for the
01:37
service
01:38
that’s just like Netflix if you get your
01:40
health insurance through your company
01:41
they might automatically deduct the
01:43
payments from your paycheck if you
01:44
signed up for a plan through the
01:45
Affordable Care Act or a private insurer
01:47
you are in charge of remembering to pay
01:50
the premium each month how much your
01:52
premium costs will be largely related to
01:54
your deductible the deductible is how
01:57
much you have to pay for your health
01:59
care before the insurance company will
02:01
start reimbursing claims the bill for
02:03
the service usually the doctor’s office
02:05
or the hospital that you went to will
02:07
send the claim aka the bill directly to
02:10
your insurance company if your
02:12
deductible is high like say six thousand
02:15
dollars that means you’ll have to pay
02:16
out-of-pocket for six thousand dollars
02:19
worth of services before your insurance
02:21
kicks in and starts reimbursing claims
02:23
but even if you haven’t met your
02:25
deductible most insurance plans do cover
02:28
almost all of the costs of routine
02:31
preventive care like getting a yearly
02:33
checkup
02:34
or a gynecological exam pretty much
02:36
every plan though defines routine care
02:38
differently so it’s a good thing to read
02:40
up on when picking a plan they make it
02:42
really confusing the type of health
02:44
insurance company you’re buying a plan
02:46
from might make a difference when it
02:48
comes to choosing which doctors you can
02:50
see if you’ve ever heard of HMOs aka
02:52
health maintenance organizations they
02:55
only cover procedures performed by
02:58
certain professionals in a network you
03:00
want to make sure that the doctor you go
03:02
to is in-network for your HMO but wait
03:05
if your health insurance comes through a
03:07
PPO or a preferred provider organization
03:11
that means that they’ll cover your
03:12
doctor visit at different rates
03:14
depending on if that doctor is in
03:16
network or not whether you get your
03:18
health insurance through an HMO or a PPO
03:20
make sure you know whether your doctor
03:22
is in network and prepared to shell out
03:25
accordingly if it’s hard to figure out
03:26
by googling you can usually call a
03:28
doctor’s office and ask them if they can
03:30
work with your insurance plan after you
03:32
sign up for a health care plan the
03:34
company might require that you choose a
03:36
primary care provider what you we made a
03:39
whole entire video for this already when
03:42
you go to a clinic or a hospital for any
03:44
kind of care you might need to break out
03:46
your wallet or a co-payment which is a
03:49
fixed amount expected to be paid to the
03:52
doctor’s office when the service is
03:53
rendered so let’s say that you spent
03:55
enough on health care this year that you
03:57
meet the cutoff for your deductible
03:59
awesome insurance will cover everything
04:02
now right well not quite you might still
04:05
need to pay in coinsurance on any
04:07
additional doctor’s visits for that year
04:09
coinsurance is usually a percentage of
04:11
the bill not a fixed amount health
04:13
insurance companies sometimes describe
04:15
it as your share of the cost of the
04:18
health service because yeh don’t we all
04:21
love sharing so you can go on about how
04:24
help there works for a ridiculously long
04:27
time but ultimately the most important
04:28
thing to understand about your health
04:30
insurance plan is as much as you
04:32
probably don’t want to pay attention
04:33
health insurance is weird and
04:36
complicated in the companies themselves
04:37
do not always get everything right and
04:39
mistakes can happen when it comes to
04:41
billing for claims read your plan when
04:43
you sign up read the bills when they
04:45
come in and make sure that your insurer
04:47
is covering everything they’re supposed
04:49
to pay for if you go to the doctor and
04:50
then suddenly get a bill for a service
04:52
you thought was covered do your research
04:54
and be prepared to fight for what you
04:56
deserve the best way to resolve a
04:58
conflict over an insurance bill is
05:00
usually to call up the company and ask
05:02
for a real live human to help you solve
05:04
the problem politeness goes a long way
05:07
when dealing with insurance companies
05:08
and remember breathe deeply you got this
05:15
thank you for joining us and if you want
05:17
to learn more about adulting with Rachel
05:19
and me you can subscribe to how to adult
05:21
at youtube.com slash learn how to adult
05:24
and if you liked this episode and want
05:26
to support this channel consider
05:28
becoming a patreon patron at patreon.com
05:31
forward slash how to adult meditation
05:43
guided sleep meditation with Hank Hanks
05:50
arm my arm talks to you about sleep it
05:55
would be really hard to send that to you
05:57
in the mail you can’t have my arm anyone
06:02
let’s do this thing
06:02
couple my legs fall off eventually this
06:04
is not comfortable anymore deep pretzel
06:09
deep principle have ibm’s new
06:13
supercomputer yes read your plan read
06:21
your plan when you sign up
06:27
read your plan it’s too long
Admin
ADMINISTRATOR
PROFILE

Posts Carousel

Latest Posts

Top Authors

Most Commented

Featured Videos