health inurance

FUTURE TECH - SHAHID

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00:00Millions of us now have health insurance under the Affordable Care Act, or what some people

00:17call Obamacare.

00:19But like many things in life, your health insurance can often be confusing and complicated.

00:25Whether you've been insured for years, or you're new to the game, understanding your

00:29policy is important to your health and your wallet.

00:34First things first.

00:35You have to pay your premium every month or your insurance could get canceled, kind of

00:39like your cable subscription.

00:42You can also think of it like a shared health care piggy bank.

00:46We all chip in each month, even if we're healthy, so the money is there when we need it.

00:51If you get insurance at work, your employer probably pays most of your premium and the

00:56rest comes out of your paycheck automatically.

00:59If you have Medicaid, you most likely don't have to pay any premium at all.

01:04The federal government and your state take care of that.

01:07If you're insured through a new health insurance marketplace, depending on your income, you

01:12may be eligible for a tax credit that pays a portion of your premium.

01:17Once you have that shiny new insurance card, you'll want to try really hard to keep it

01:22in your wallet.

01:23To better your odds at staying healthy, be sure to take advantage of the free preventive

01:28services that all new insurance plans provide.

01:34But of course, stuff happens and that's when insurance really comes in handy.

01:41Now having insurance helps a lot, but it doesn't mean all your health care is going to be free.

01:47There are lots of details about your insurance plan that affect how much you pay when you

01:51get sick or injured.

01:54If you have Medicaid, a lot of these services could very well be free.

01:58Otherwise, you'll likely have to pay something when you go to the doctor or fill a prescription.

02:04This is called a copay when it's a specific dollar amount, like $25 per visit, or coinsurance

02:10if it's a percentage of the bill.

02:13There's also the deductible.

02:15That's how much comes out of your own pocket before your insurance starts paying.

02:20Depending on your plan, you might have a deductible for all your care or it might only apply to

02:24some types of care, like hospital stays and prescriptions.

02:28So read your plan material, because it could add up to thousands of dollars.

02:35Another important part of your plan is the out-of-pocket maximum.

02:39This is the most you'll ever have to pay in any one year, at least for the benefits your

02:43plan covers.

02:44Your insurer will pay 100% of anything beyond the maximum for the rest of the year.

02:51It can be just as confusing dealing with prescriptions.

02:55Your plan has a list of drugs it will pay for, called a formulary, but the prices vary.

03:01Check with your doctor or pharmacist because a generic drug might fix you up the same as

03:05a brand-name drug, but the price difference could be huge.

03:10So those are the costs typically involved, but remember that they'll be affected by your

03:15insurance plan's provider network.

03:18This is a list of doctors and hospitals that are connected to your plan.

03:23Insurance companies negotiate discounts with these providers.

03:26Stay in network and the discounts get passed to you.

03:30Go out of network and you could end up paying full price.

03:34And remember that out-of-pocket limit?

03:36It won't work if you go out of network.

03:39In some plans, like HMOs or EPOs, your insurance would pay nothing if you go out of network.

03:45In other plans, like PBOs, your insurance will cover you no matter where you go, but

03:50you'll pay a lot more if you go out of network.

03:53Also, if you want to visit a specialist, like an orthopedist, some plans require a referral

03:59from your primary care doctor.

04:02Sound easy enough?

04:03Well, sometimes staying in network can be tricky.

04:07In a hospital, it's possible that your surgeon could be in network while your anesthesiologist

04:12is not.

04:13If this happens to you, don't be afraid to negotiate with your provider or file an

04:18appeal with your insurer.

04:20So as you can see, there's a lot to think about when you choose an insurance plan each

04:24year.

04:25Some plans may have low premiums, but fewer doctors or hospitals and high deductibles.

04:31There are tradeoffs, and understanding and choosing among plans isn't always easy.

04:36Remember, if you have questions, call your health plan and ask, or check with your hospital

04:41or doctor.

04:42If you still have questions, your state insurance department or consumer assistance program

04:46can help.

04:47With the Affordable Care Act, there's new support for consumers, so take advantage of

04:52it.

04:53Having health insurance protection is a good thing, especially when you know how it works.

04:58We hope you're now better prepared for the next time you have to pull that insurance

05:02card out of your wallet.

05:04Stay safe, America.

05:12Stay safe, America.

05:13Stay safe, America.

05:14Stay safe, America.

05:15Stay safe, America.

05:16Stay safe, America.

05:17Stay safe, America.

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