Aetna and AARP: 15-Minute Health Insurance Guide (Part I)



let's start hi and welcome we know how confusing it can be to buy health insurance these days and if you used to be in a plan where you worked shopping for your own individual plan can be even more of an eye-opener we hear it from people all the time it's tough to understand the ins and outs and to know what to look for that's why we've put this together this is brought to you by Aetna and AARP it's not a sales pitch honest it's a straight up look at how to buy individual health insurance we're going to point out some important things to look for and to expect when you consider a health plan for you or your family like cost cost is one of the first things people look at when they're checking out health insurance understandable but cost is more than just premiums its deductibles co-pays coinsurance maximum out of pockets and more so you need to look at the big picture of cost now just as important is the coverage after all you're buying this to make sure you are covered when you need it so you need to know what's covered and what's not from doctors and tests to preventive care and medications and even that first day in the hospital so let's get started this will take about 15 minutes premiums and deductibles ah the monthly plan premium that's what people usually think of when they think of cost but the plan premium is actually based on a lot of different factors from type of coverage to deductibles to networks and yes even your health first let's define just what a deductible is the deductible is the amount of money you pay out of your own pocket for covered services before the health insurance plan pays for those services it's an annual amount so each year it resets and you start again on your deductible since you'll be paying this you need to ask yourself how much can I afford to pay out think of it this way on Tuesday life is good no problems on Wednesday you develop this weird pain in your leg you need to go to the doctor and get a bunch of tests then you need to write out a check for all that how big of a check are you comfortable writing five hundred dollars five thousand dollars when you're considering premiums remember that deductible plays a big part a high deductible often results in a lower premium and on the flip side a lower deductible often means a higher premium since you need to pay the deductible out of your own pocket before insurance begins to pay for covered services think about what is going to be best for you your family and your budget Co considerations when you're considering cost also take a look at coinsurance and co-pays basically that's where you and the health insurance plan share the cost and it's important to know what that is first there's coinsurance once you meet your deductible your plan goes to work for you but it doesn't pay 100% of your costs you still have to pay some of them that's the ko part of coinsurance you're both paying something while each plan is different a pretty typical plan with coinsurance will have health insurance paying 80% of the expense while you pay 20 percent sometimes coinsurance applies only to certain things like hospitalization staying in your network which we'll talk about later on can also affect your coinsurance it can reduce or even eliminate it the important thing to know is what you'll be paying out-of-pocket to cover your portion of that coinsurance oh and note on the out-of-pocket take a look at the out-of-pocket maximum in your plan if it shows an annual maximum this is a good indicator of the total expenses you may have to pay in that period if you or your family need a lot of health care as long as we're talking about Co stuff don't forget copay copay is where you pay a fixed amount save $25 for a doctor visit or $10 for a prescription and the plan pays the rest co-pays usually come into play after you meet your deductible if there is a deductible a health plan should tell you whether co-pays for doctor visits or prescription drugs count toward the deductible and toward the maximum out-of-pocket if you're not sure ask the company this can be an important part of helping to control your costs and a good way to weigh one plan against another hospitals and networks you can always plan on when and what kind of health care you'll need you know that weird pain in your leg well turns out you need surgery and that can be big bucks the last thing you want to worry about is paying a bill equal to the cost of a hat that's why having health insurance is so important look for plans that cover emergency room care outpatient surgery and hospital admission starting day one of your stay since that first day in the hospital can be the most expensive you'll also want to review the limits on what's covered particularly the big items like hospital stays outpatient treatments tests like MRIs and even your doctor visits and prescription drugs and check what's called annual or lifetime maximums two hundred thousand dollars sounds like a lot but it's not nearly enough it should be at least in the millions and here's where the network comes into play health insurance plans often distinguish benefits and even caused by whether something is in network or out of network each plan has a list or network of contracted doctors hospitals pharmacies therapy centers you name it you will definitely want to find out if your doctor Hospital and pharmacy is in-network because when you stay in that network you'll often pay less than if you go out of network say for example you need physical therapy and you pick a center that is out of the network that coinsurance you need to pay could double and that could be a bigger ouch than the pain in your leg stay well preventive care is getting more attention these days and it should if you're proactive with your health if you take care of yourself chances are you'll have a healthier life health insurance companies recognize this and some will even offer preventive care at really reduced rates or at almost no cost at all for example an annual physical you do get one don't you or routine GYN exam some plans may charge you just a copay like $25 and then waive your deductible for this type of service that could be the best 25 bucks you'll ever spend you can also see if the plan offers discounts on things that contribute to a healthy lifestyle like weight management and even gym memberships you might be surprised at what's included it truly pays to take care of yourself and your family so look for this kind of coverage and take advantage of it

2 Comments

  1. 6:17 "…and that could be a bigger ouch than the pain in your leg" – Everything that's wrong with medical care in the US packed into one sentence.

  2. Great video
    Check out wwwmedhelp. com

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