Health Insurance terms explained and made clear – what is co-pay, coinsurance, deductible, hmo, ppo

Today I would like to go over certain health insurance terms that might be confusing and try to help you demystify the health insurance terms so let's get started let's start with understanding what the premium is while the insurance premium is the amount you pay monthly for your health insurance plan the cost will vary by person and if your income.

Is below 400% of the federal poverty level you may receive subsidies from the government to reduce your cost you pay a portion of the premium even if you don't use medical care that month if you don't pay your portion of the premium the policies canceled doctors will want their money back and you can sign up again until next open enrollment period.

The open enrollment is the window of time during which you can apply for health insurance or modify a plan to include your spouse and/or your children policyholders are unable to adjust their plan until the next open enrollment unless they experience a qualifying life event thence include a marriage divorce birth of a child changes to individual.

Or household income or interstate residents relocation for year 2018 the open enrollment is November 1st 2017 to December 15 2017 however if you are enrolling through covered California you might have until January 31st 2018 to apply for health insurance what is a penalty if you can afford health insurance but choose not to buy.

It you must pay a fee called the individual shared responsibility payment the things sometimes called the penalty fine or individual mandate here's the penalty for year 2018 it is calculated in two different ways first as a percentage of your household income or per person you'll pay whichever is higher the fee.

Is either 2.5% of your income or 695 dollars per adult what is a coinsurance it's the amount you pay to share the cost of covered services after your deductible has been paid the coinsurance rate is usually a percentage for example if the insurance company pays 80% of the claim you pay the remake which is 20%.

What is a co-payment a co-payment is one of the ways you share it in your medical costs you pay a flat fee for certain medical expenses for example you pay 10 dollars for every visit to the doctor while your insurance company pays the rest the coinsurance and co-payments is very often confused keep in mind the coinsurance is usually a percentage and.

The co-payment is a fixed dollar amount what is a deductible a deductible is the amount of money you must pay each year to cover eligible medical expenses before your insurance policy starts paying however not all services are subject to the deductible so carefully look at the summary of benefits in order to see what is and what is not subject.

To deductible this will save you lots of money and possibly paying for unnecessary high premiums out-of-pocket maximum the out-of-pocket maximum is the most money you will pay during a year for coverage it includes deductibles co-payments and coinsurance but isn't addition to your regular premiums beyond this amount the.

Insurance company will pay all the expenses for remainder of the year what is an HMO an HMO is a health maintenance organization that provides comprehensive health care services for enrollees in a particular geographic area HMOs require the use of specific in network plan providers for example Kaiser is an HMO you can only use your.

Health plan at Kaiser and you will need to select the primary care doctor and always get referrals to the specialists PPO a PPO is a preferred provider organization is a health insurance plan that offers greater freedom of choice members of PCOS are free to receive care from both in-network and out-of-network providers but will receive the highest.

Level of benefits when they use providers inside the network I highly advise anyone to check the network of doctors before signing up for a PPO plan what is an EPO EPO stands for exclusive provider organization it's a more restrictive type of preferred provider organization plan under which consumers must use providers from the specified.

Network of physicians and hospitals to receive coverage there is no coverage for care received from a non-network provider except in an emergency situation well what is a network a network is a group of doctors hospitals and other health care providers that insurance companies contract with to provide services and pay discounted.

Rates you will generally pay less for services received from providers in your network in network provider is a healthcare professional hospital or pharmacy that is part of the health plans network or preferred providers you will generally pay less for services received from in-network providers because they have.

Negotiated a discount for their services in exchange for the insurance company sending more patients they away out-of-network provider is a healthcare professional hospital or pharmacy that is not part of a health plans network of preferred providers you will generally pay more for services received from out of network providers if you have a PPO.

Plan and you might not get any services covered out of network if you have an HMO plan that's why it is very important to check your doctor's clinical pharmacy before you sign up for a plan obviously if you want to keep your daughter's health savings account or HSA it's a personal savings account that allows participants to pay for medical expenses.

With pre-tax dollars HSAs are designed to complement a special type of health insurance called an HSA qualified high deductible health plan high deductible health plans typically offer a monthly lower monthly premiums than traditional health plans with an HSA qualified high deductible health plan members can take the money.

They save on premiums and invest it in the HSA to pay for future qualified medical expenses as always thanks for watching and please comment on the video kzcover – we love helping people and we'll respond ASAP love this video don't forget to share your happiness with your friends and please please support us by subscribing.

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