I'm too Irish for this conversation. I hear my dad in my head screaming "walk that shit off" everytime I hurt myself as a kid. I laughed when she used $500 as a deductible payment example. More like $6000 at least. I couldn't reach that quota 😂
So let me get this straight.... I have to pay a fee every month, just to have to STILL pay until I hit a certain amount (my deductible), and THEN that’s when my insurance company will even start considering paying SOME (not all) of the expenses? So I’m paying to have the privilege of paying? How is this right? If I’m paying a monthly fee shouldn’t I be guaranteed covered healthcare on the spot as opposed to having to still pay?
Sounds crazy doesn’t it?😂😂It’s like a pool. The premiums we pay every month go into this pool to cover for other people’s big hospital bills and what not. I believe that’s the only way our health insurance system can function in the US. It depends on the Premiums/Deductibles of the Members.
you can be guaranteed full healthcare coverage right on the spot in countries like Brazil for instance, fortunately not all places have the same healthcare system.
its “to incentivize people to find cheaper care” and keep people from wasting medical resources. It’s a shame no other country or system has found a better solution, I guess the insurance companies and their lobbyists will just have to keep making tons of money
I did the math. It's cheaper for me to have a cavity, two eye exams, a $400 pair of glasses, a $250 pair of contacts, and 2 dental checkups RETAIL on the HIGH END of avg costs, than to have a PPO plan through my employer. $2100 vs $3400 a year. And that's not including all this deductible and co-pay nonsense!! I'm taking the penalty this year, and cashing in on my family's genes. I'm sorry for those born with pre existing conditions. I really am. It's not fair, and the system is built to farm you.
Yep insurance in the US is shit. Where I'm from you actually get more out of insurance than you pay. SO it's worth it where I'm from. BUt in the US its a really shitty insurance system.
Austin but what about if you do get sick. Have cancer or a heart attack no one ever knows. Private insurance plans work better for those who are healthy. Allow me to help. Reply back to me if you want insurance for the right reasons.
The point of insurance is to pay for the big stuff. Like surgeries or hospitals stays that cost tens, even hundreds of thousands so you don't go bankrupt. It's probably worth it to have higher deductibles if you have a decent rainy day fund. Sadly most Americans don't
I'm not American and I have always struggled to understand how health insurance and their plans work in the US as I was curious. This video is the by far the best one to explain it and now I can rest in peace.
It's actually very similar to my countries health insurance, but we just don't have the deductible. I actually like the deductible though as it can reduce your premium significantly and turn your health insurance more into a plan thr just covers the emergencies. We could do with tht type of flexibility
Here in NZ, all I know that when I went to hospital after a biking injury, I got treated then I left, having paid only $1.00 (that's for the can of Coke I bought at the vending machine).
This is crazy if you’re young and don’t go to the hospital that much most of time you don’t even reach that deductible so you always have to pay for everything then next year comes and everything starts over 😮 you practically get robbed
If only it were this easy. Out-Of-Pocket-Maximums are meaningless because the insurer decides what it is applicable to. In 2014 I learned that my possible costs were infinite because many charges were not applicable.
Wish I could've taken a class like this. Just graduating from university and got an offer for a salary job with benefits; wish I learned about all this stuff from uni.
From my family's experience, this is the best case scenario. Not mentioned is the constant mistakes in billings by both the MDs and the labs, and the hospitals, and the hours on the phone and the agony people go through to fix the mistakes. BTY we are a healthy family with two kids and only need (so far) annual preventive check up and such. God help the people who need constant help, and stuck in the health care's jaws !!!!
So what happens by having a high deductible and being somewhat healthy and never reaching your deductible. Do you just pay for the premiums and the health care? so why do we need the insurance for if we are having to pay them both?
So... I make 28,000 a year 7,000 a year goes on tax, social security, federal and Medicare, i end up with 21,000. Then my health insurance cost 2,400 a year (100 every two weeks) I really end up with $18,600 a year. They expect you to survive on this money. 😑
Yea you end up with 18,600 a year until the year you get seriously injured and then you have to max out your deductible. Which probably upwards of 10,000. Then you're down to less than 8600 that year and your life is in shambles.
@@hanaasiraj3225 Oh trust me, as an American a lot of us think this system is idiotic. But we have enough idiots to support the system, so the show must go on.
I love how optimistic this is.... "Lets say your premium is $200".. Pfft, I wish.. Cheapest plan I can find is almost double that... And "Let's say your deductible is $500" HAH!!! HAHAHAHAHAHA!!!!!! More like five THOUSAND dollars... American healthcare is a really bad joke.
Thank god, im living in Denmark. You don't have do anything, minior injuries, broken legs, birth, cancer you name it, no need for a special insurance ! You just live your life and pay tax and the system takes care of you
dunno what you mean here... But the living standard is very high and this is the land of opportunities because you don't need rich parents to take a college degree. This is also covered by the tax. During the school jer you get 800 dollars in subsidies per student pr. month
I never comment but this video helped me so much! I damn near picked a 3,000 deductible with a premium of 39.50 and an out of max at 5,000. Instead I got a 500 deductible on a 12.50 premium with an out of max at 4,500. This also comes with pretty much $0 in copays. Thank you so much that would have been the biggest mistake in my adult life.
Oh my. I have my health insurance thru my employer for 2 years and HR didn't explained to my about it. And this video of 4:55mins explained to me everything. I hope HR's in every company present this video to new hires.
Usually, I never comment on TH-cam channels, but your channel is so convincing that I never stop myself from saying something about it. You’re doing a great job Man, Keep it up.
This video really helps me understand health insurance and how to really know what to expect with certain plans and services. Thank you i can now comfortably teach this to my class mates.
Nice. Only thing it missed was covered vs uncovered expenses. Only covered expenses count toward your deductible. Make sure your provider gets the insurance company to say it’s covered. Otherwise YOU’RE paying and it doesn’t count for anything
Super informative! I did notice that I couldn't use closed captions though. Thankfully, TH-cam studio and other online services can make that an easy fix! As 360million people rely on utilizing close captioning to understand videos, adding them to your videos can help your message reach a wider group of people and promote inclusivity! Thanks!
In Australia it works differently (if we choose to get private health, we have universal health care for those who choose not to). We pay the monthly premium and then have waiting periods for each service. For example things like optical have a 2 month waiting period, things like dental surgery have a 12 month waiting period etc. But once you have served that waiting period, it doesn't restart again each year. You've served the waiting period even if you change private health insurers. Every now and then insurers will even have a deal where they waive all 2 and 6 month waiting periods. Once you have served your waiting period, the insurer will contribute a certain amount or percentage towards every service you are covered for, up to your maximum allowance every year. That maximum allowance resets every year, but the waiting periods don't. Edited to add: I've never heard of deductibles or maximum out of pocket, we don't seem to have that here with private health.
Premium is a monthly membership you pay every month that covers like breast cancer,diabetes, cholesterol is covered by premium.At the first stage of the begging of the year you pay for most of your healthcare until you reach the deductible.A deductible is amount of money you how to pay for your care before the insurance share the cost.now when you get health services you will pay for all them health services until you pay the 500 dollars but once you paid all of that then that's when thing will changes then when you enter the second stage that's now when you get healthcare services your insurance company will share the plane but it depends on the plan you choose.
What if for the entire year all you did was your annual physical which is considered a preventative care. Does hat mean you will be required to pay the FULL deductible at the end of the year even though all you did that year was see ONE doctor for your annual physical?
Any system that forcefully requires a middleman who profits from being a middleman. It is the difference between legitimately making money, and taking money. The reason everything cost so much for health "services" is precisely because of the Insurance system they propped up. You either pay them to be middlemen, or they will ruin you financially when you do need help.
I have an autoimmune disease that has no known cause or cure. My medication costs over 6k per month without insurance. My OOP max is $2800. So assuming the insurance holds true to that figure I have a $2800 annual fee for having a disease I didn't choose. Cool.
Knowing is power! my ER visit bills from CHI St.Luke's included charges for pain-relief injections never done, facility & procedures for Severity Level 4 and Level 5, while I spent total 3.5 hours sitting on a chair in their waiting room - (real severity - Level 2, as max) with some labs work and CT test performed and met the doctor at the very end - in 3+ hours after arrival... They say with straight face that extra & upcoded charges are correct - WATCH OUT FOR THAT!!! - you may need lawyers... BTW: who has to check the charges levels: Me or Insurance co I pay monthly?
One thing you can be sure of: the insurance company will try to pass on as much cost to you as possible, all the while raising your premiums every year. Your copays go up, and your benefits will be less. That’s how the game works. They have the game set up in their favor. You can be sure of that.
Hi there! I could have sworn I’ve been to your videos before, but I realized it’s new to me after browsing through some of the published videos. Regardless, I’m definitely happy I stumbled upon it and I’ll be subscribing it and checking back frequently!
Baffled by premiums, deductibles and out-of-pocket maximums? NO, not really :-) That is because I am Canadian! I am indeed very happy to be Canadian! Now that I am healthy, I pay more than I take out.. People that need care are taken care for free. I might one day need the same.. We take care of each other! Simple :-)
you know in America people get so angry for such thing if it does exist in America such system .. there is always huge amount of hate against each other as people to people only .. but for the Gov senators and congress members who is getting all of it for free and for doing nothing !! OH its OK they are the Masters !! what a mentally amazing culture !!
You do not have as good as doctors, and the government determines who dies and who lives because you do not have enough people or resources. I do not have healthcare and I would rather keep it that way than have a single payer, because I am not stupid.
The deductible is and copay is much higher than this. And if you reach your max out of pocket for the year, most like your premium will go up. Even worst they might choose not to insure you anymore. What’s more messed up is there are lots of fine prints when a insurer can actually not pay.
The NHS (National Health Service) in UK. Everyone working pays and puts a little bit in the pot for everyone including themselves. A lot less than the premiums and co-pays etc in these examples. (Which of course is the profit margin for the insurance companies.) That's it. Of course with mass immigration they are having to build more hospitals etc and there is waiting lists for certain non emergency things. But it's not about profit for health Insurance companies. It's about health for all from cradle to grave supported by each other. A form of 'socialism' despised in USA.
At least you don't have the complicated system we have in Canada where we go to the hospital and after extensive treatment, we leave and the biggest expense is the gift shop purchase of a box of chocolates! Then comes all the paperwork.... what to do with the receipt for the box of chocolates?
Well, my premium is just about the same amount as I'd pay out of pocket for my asthma medication. I might as well pay $320 a month to get the medication along with dental, vision, and preventative care visits. It's also nice to know that I won't go bankrupt if something bad happens and I end up in the hospital. Still, I envy Canadians.
Damn, it sucks to live in America. I mean it certainly beats a second or third world country, but we are like the bottom of the barrel of the first world countries.
So if a plan has 30% co-insurance, does that mean I pay 30% of a cost once I enter "stage 2?" for example $500*.3=$150, so I'd pay $150 for a $500 procedure/visit and the insurance pays the extra $350?
As a young adult, 20 in 4 months, i just lost passport and Anthem. I didnt understand how insurance really worked because it was through my parents. Now that im learning to individualize, i was lost. But still, i am not sure the smartest monthly insurance plan or company as a young adult making 9.25 an hour..
If you can't get health care through your employer, then you should qualify for subsidized health care. First find out if there is assistance from your state government. If not, then you should qualify for the PREMIUM TAX CREDIT (PTC), which is a type of federal subsidy available for people who make less than 400% of the federal poverty level (federal poverty level is currently about $12,140/yr for a single person, but higher in AK and HI). You can get the premium tax credit if you apply for a qualifying health care plan at the online marketplace (www.healthcare.gov). However, the enrollment period is in December of each year. If you claim the PTC, then you will get a tax form 1095-A and you will have to submit a form 8962 when you file your federal income tax. Most of the numbers are on the 1095-A, so it's not difficult to fill out. I claim the PTC because it's the only way I can afford health insurance at this time. I'm 54 years old, and my monthly premium is $793 (increasing yearly), but it's subsidized by the federal government. You can get more information about the premium tax credit at the IRS web site or the online healthcare marketplace.
They should take the cutest cartoon shit out and explain plainly. NO ONE, ABSOLUTELY NO ONE IN THE US IS COMFORTABLE WITH THEIR INSURANCE. well rich people are, but everything is swell where money is no object
We kind of do what the US do. So here in Ireland, if you choose to go private instead of public, so if you have a pre-exsisting condition, depending on the plan you were on previously, you will or will not be covered. I was on my moms policy up until August 2021, then i went onto a new system. I only pay 68.88 euro a month which is about 70 some bucks a month. After that, they do the rest.
How about this. Our government says....As a law abiding citizen. If you’ll go out and get a steady job or jobs. Pay your taxes which keeps our economy flowing and running smoothly for 25 years. You will be rewarded for your dedication and hard work to our great country with absolute, top to bottom, everything covered healthcare?
And the other kicker is that the american working class work so many hours it's impossible to get time to even go to the doctor, and the appointments are months out ,the irony of it all. I'm making it a priority to see every dr and specialist. Work-life balance and selfcare is my number one priority for 2021
So what happens if your Deductible is $15,000, what if the year is over and you haven't paid that deductible do you have to start over next year SMH 🤦🤦
Technically not "every dollar" after the out of pocket maximum. It has to be THROUGH your insurance still, and you won't. So, for example, if it's through somewhere that your insurance doesn't cover, it won't count.
I’m still confused cause I don’t have bison insurance but want to get it with VSP. It says the copay would be $15 but when I called to a optometrist that also take VSP insurance, they told me it would $70. If I’ll end up paying more for an eye exam even with insurance, what am I doing paying for eye insurance in the first place since it not really saving me anything?
Here in New Zealand we have free universal public healthcare that cover most of our healthcare needs (such as treatment at public hospitals and prescription drugs covered by PHARMAC) but we do need private health insurance to cover things not covered by the public healthcare system (such as private hospital, drugs not covered by PHARMAC, mental health and dental). I may buy supplementary private health insurance from NIB or Southern Cross.
![[Full] 4 ต่อ 4 Celebrity EP.910 | 22 ก.ย. 67 | one31](http://i.ytimg.com/vi/4TR3MVpOiw8/mqdefault.jpg)
This was super helpful and depressing, lol. Thank you
Im learning more from youtube than I did in high school
coming from a sophomore still in high school, my teacher is having us watch this video to learn about insurance lol
This is why the school system is broken. We don’t need more education after middle school, the rest should be optional depending on careers...
@@ashrice4642 I'm a junior in high school. Thank god some teachers teach us stuff that's actually useful.
Welcome To the Institute of binge watch and prophecy
Yes! I am getting many degrees from TH-cam university. LOL God bless everyone who takes the time to upload the videos.
Finally. Someone explains this demonic system in a way I can understand. Thank you!
EricaYE6 EMPHASIS ON DEMONIC
my feels exactly haha :/
first world country btw
Demonic IT IS! 😇
I'm too Irish for this conversation. I hear my dad in my head screaming "walk that shit off" everytime I hurt myself as a kid.
I laughed when she used $500 as a deductible payment example. More like $6000 at least. I couldn't reach that quota 😂
So let me get this straight.... I have to pay a fee every month, just to have to STILL pay until I hit a certain amount (my deductible), and THEN that’s when my insurance company will even start considering paying SOME (not all) of the expenses? So I’m paying to have the privilege of paying? How is this right? If I’m paying a monthly fee shouldn’t I be guaranteed covered healthcare on the spot as opposed to having to still pay?
That is correct. If you read the ACA, you can tell it was written by the health insurance companies.
Sounds crazy doesn’t it?😂😂It’s like a pool. The premiums we pay every month go into this pool to cover for other people’s big hospital bills and what not. I believe that’s the only way our health insurance system can function in the US. It depends on the Premiums/Deductibles of the Members.
Dude I work in this field and it fucking is bonkers that this is legal. You just described the mandatory health insurance industry.
you can be guaranteed full healthcare coverage right on the spot in countries like Brazil for instance, fortunately not all places have the same healthcare system.
its “to incentivize people to find cheaper care” and keep people from wasting medical resources. It’s a shame no other country or system has found a better solution, I guess the insurance companies and their lobbyists will just have to keep making tons of money
I did the math. It's cheaper for me to have a cavity, two eye exams, a $400 pair of glasses, a $250 pair of contacts, and 2 dental checkups RETAIL on the HIGH END of avg costs, than to have a PPO plan through my employer. $2100 vs $3400 a year. And that's not including all this deductible and co-pay nonsense!!
I'm taking the penalty this year, and cashing in on my family's genes.
I'm sorry for those born with pre existing conditions. I really am. It's not fair, and the system is built to farm you.
Yep insurance in the US is shit. Where I'm from you actually get more out of insurance than you pay. SO it's worth it where I'm from. BUt in the US its a really shitty insurance system.
Dont break a bone or even get sick. Those antibiotics are over a couple grand a pop.
Austin but what about if you do get sick. Have cancer or a heart attack no one ever knows. Private insurance plans work better for those who are healthy. Allow me to help. Reply back to me if you want insurance for the right reasons.
The point of insurance is to pay for the big stuff. Like surgeries or hospitals stays that cost tens, even hundreds of thousands so you don't go bankrupt. It's probably worth it to have higher deductibles if you have a decent rainy day fund. Sadly most Americans don't
$250 for contact lenses???,in Scotland i pay about £17pm(about $22) for monthly wear contact lenses.
I'm not American and I have always struggled to understand how health insurance and their plans work in the US as I was curious. This video is the by far the best one to explain it and now I can rest in peace.
Same, except I AM from America so i probably won't rest in peace anytime soon knowing that the health system here is fucked 🤷♂️🙂
As an American, we don't know either.
Trust me, I know so many Americans into their 40s and 50s, who don't understand either. Only, because no one really bells the cat?!
It's actually very similar to my countries health insurance, but we just don't have the deductible.
I actually like the deductible though as it can reduce your premium significantly and turn your health insurance more into a plan thr just covers the emergencies. We could do with tht type of flexibility
this woman is making the out of pocket maximum sound like we are blessed. oh, thank you lord for this gift from you.
not a PENNY more... ;-) *wink and a hand shaped like a gun pointing right at ya*
Haha ikr, some out of pockets are up to 100 000 $ so good luck getting there
Well yes, because it means you spend a fraction of the costs involved
@@dannymain542literally they arnt. The average out of pocket is 8000
This is literally a scam.
Yup!
That’s the American dream
Biggest mlm ever made
I'm watching this for school rn 😭😭
Then don’t have insurance?
Here in NZ, all I know that when I went to hospital after a biking injury, I got treated then I left, having paid only $1.00 (that's for the can of Coke I bought at the vending machine).
How nice. American Healthcare is the biggest scam ever. They extort the poor and we either die naturally or die in debt
I was in the er for 3 hours max and got an IV paid 700$ with insurance 😭😭😭
@@ruthmartinez5604 Was in the 🇺🇸 States?
Smaller population is easier to make health insurance free funded by taxes
@@americanchauvinist1210 how so
I'm preparing myself to be an adult. Thank you for this!
This is crazy if you’re young and don’t go to the hospital that much most of time you don’t even reach that deductible so you always have to pay for everything then next year comes and everything starts over 😮 you practically get robbed
You just described me here. I almost went for it but decided to do a little research before diving deep and now I realized I almost fell for a scam
Hot damn! insurance company's are making a ton of money off people!
Well i mean they gotta pay for their member's stuff some how
I'll give you a bag of bandages and you do it yourself then
If only it were this easy. Out-Of-Pocket-Maximums are meaningless because the insurer decides what it is applicable to. In 2014 I learned that my possible costs were infinite because many charges were not applicable.
When I checked what qualifies towards my out of pocket maximum it said: "Your Death" 🤷♂️
@@OsirisT guess ill die
@@baileymorris4990 same
I despise how this video has cheerful music, narration, and animations when explaining a system that extorts its "members" every single day.
lol they really be making it seem like its a joyful thing when its a pain sometimes
Literally doesn't extort anyone but ok
I teach school and teach an "Insurance Operations" class and this is an amazing video. Excellent job!
Wish I could've taken a class like this. Just graduating from university and got an offer for a salary job with benefits; wish I learned about all this stuff from uni.
From my family's experience, this is the best case scenario.
Not mentioned is the constant mistakes in billings by both the MDs and the labs, and the hospitals, and the hours on the phone and the agony people go through to fix the mistakes.
BTY we are a healthy family with two kids and only need (so far) annual preventive check up and such.
God help the people who need constant help, and stuck in the health care's jaws !!!!
So what happens by having a high deductible and being somewhat healthy and never reaching your deductible. Do you just pay for the premiums and the health care? so why do we need the insurance for if we are having to pay them both?
Because the government punishes you for not having insurance too. damned if you do, damned if you dont.
You need to so that you can fatten the insurance companies coffers! Now do you consumer duty! 'Murica!
Also, in some cases, it’s cheaper to pay the monthly premium than to pay out of pocket for the ridiculous prices of preventive care.
So let's buy have it for the true reason. You shouldn't have to pay high deductibles to get coverage. Allow me to help. And I can explain.
So... I make 28,000 a year 7,000 a year goes on tax, social security, federal and Medicare, i end up with 21,000. Then my health insurance cost 2,400 a year (100 every two weeks) I really end up with $18,600 a year. They expect you to survive on this money. 😑
Worst case your taxes would be $2200/yr total on this money, most of which is social security.
Lets thank precious donald for making America great again
Yea you end up with 18,600 a year until the year you get seriously injured and then you have to max out your deductible. Which probably upwards of 10,000. Then you're down to less than 8600 that year and your life is in shambles.
So this doesn't include the house bills and car insurance? This is America for you
Its called make more money
This video may have come out in 2014 but it still explains the system better than most in the present day. Much appreciated!
If someone like me can finally understand something like this, you’ve done a great job. Thank you for the video!
I was enjoying this vid until she said that is starts again each year 😂
Wow so if i reach stage 2 near the end of the year,I start all over again?thats not fair at all.
jenjen0597 yep. Most people wont reach that stage though...
I don't think health insurance is built to be fair, I think it is built more to make insurers money
I thought you just pay a monthly fee and they pay everything. 🙄 Glad to be in Canada.
The rest of the modern world must think we're idiots. (:-(
Yes all the 33 countries that do have that kind of a system we certainly do!
But but but the government taking care of its citizens is literally socialism!!!!1!! VeNezUeLa!!!!!!!!
@@derekrequiem4359 lmaoo ikr
Yes as a British person I do think this system is idiotic
@@hanaasiraj3225 Oh trust me, as an American a lot of us think this system is idiotic. But we have enough idiots to support the system, so the show must go on.
I love how optimistic this is.... "Lets say your premium is $200".. Pfft, I wish.. Cheapest plan I can find is almost double that... And "Let's say your deductible is $500" HAH!!! HAHAHAHAHAHA!!!!!! More like five THOUSAND dollars... American healthcare is a really bad joke.
@ElwoodBlues-hy4qk If only we could get a dispenser over here.
Thank god, im living in Denmark. You don't have do anything, minior injuries, broken legs, birth, cancer you name it, no need for a special insurance !
You just live your life and pay tax and the system takes care of you
It depends on what you earn, but the loweste is 44,8 (2016) and highest is 56 %
nope and we are very happy
dunno what you mean here... But the living standard is very high and this is the land of opportunities because you don't need rich parents to take a college degree. This is also covered by the tax.
During the school jer you get 800 dollars in subsidies per student pr. month
56 % so you have 44 % left.
So 56 % is our highest tax
Same in Uruguay!
I never comment but this video helped me so much! I damn near picked a 3,000 deductible with a premium of 39.50 and an out of max at 5,000. Instead I got a 500 deductible on a 12.50 premium with an out of max at 4,500. This also comes with pretty much $0 in copays. Thank you so much that would have been the biggest mistake in my adult life.
really nice! Do u know the exact name of you're plan & the provider if u dont mind telling thanks best regards
Who’s your provider?
What's the name of your insurance please?
out of 3 videos I've watched on health insurance this one helped me understand the most (currently working on adult)
This is the type of stuff I wished I learned in school. Thanks!
Oh my. I have my health insurance thru my employer for 2 years and HR didn't explained to my about it. And this video of 4:55mins explained to me everything. I hope HR's in every company present this video to new hires.
This was the best explanation of how health insurance works I've ever seen. So simple and to the point. Really Helpful!
Usually, I never comment on TH-cam channels, but your channel is so convincing that I never stop myself from saying something about it. You’re doing a great job Man, Keep it up.
Corruption at its finest
$500 deductible? $2000 maximum out of pocket? HAHAHA! when was this video made? The early 2000s? The 90s perhaps?
This still exist. For low cost plan
Alec you can still have a plan you want. Allow me to explain new private plans that protects you the way you want
Thank you so much for finally helping me understand how the healthcare insurance costs work.
This video really helps me understand health insurance and how to really know what to expect with certain plans and services. Thank you i can now comfortably teach this to my class mates.
Nice. Only thing it missed was covered vs uncovered expenses. Only covered expenses count toward your deductible. Make sure your provider gets the insurance company to say it’s covered. Otherwise YOU’RE paying and it doesn’t count for anything
Thanks for explaining the health care key concepts in such a easy to understand way!
Super informative! I did notice that I couldn't use closed captions though. Thankfully, TH-cam studio and other online services can make that an easy fix! As 360million people rely on utilizing close captioning to understand videos, adding them to your videos can help your message reach a wider group of people and promote inclusivity! Thanks!
very helpful video thanks. however, this insurance thing sounds like a big scam to me
thank u for also being one of the few that explains these confusing terms!
In Australia it works differently (if we choose to get private health, we have universal health care for those who choose not to). We pay the monthly premium and then have waiting periods for each service. For example things like optical have a 2 month waiting period, things like dental surgery have a 12 month waiting period etc. But once you have served that waiting period, it doesn't restart again each year. You've served the waiting period even if you change private health insurers. Every now and then insurers will even have a deal where they waive all 2 and 6 month waiting periods. Once you have served your waiting period, the insurer will contribute a certain amount or percentage towards every service you are covered for, up to your maximum allowance every year. That maximum allowance resets every year, but the waiting periods don't.
Edited to add: I've never heard of deductibles or maximum out of pocket, we don't seem to have that here with private health.
Thank you for this VERY helpful video!
This is a really good video that breaks down health insurance.
Beautifully explained! Thanks for sharing!!!
Premium is a monthly membership you pay every month that covers like breast cancer,diabetes, cholesterol is covered by premium.At the first stage of the begging of the year you pay for most of your healthcare until you reach the deductible.A deductible is amount of money you how to pay for your care before the insurance share the cost.now when you get health services you will pay for all them health services until you pay the 500 dollars but once you paid all of that then that's when thing will changes then when you enter the second stage that's now when you get healthcare services your insurance company will share the plane but it depends on the plan you choose.
Thank for explaining it in such a simple way to understand.
Awesome. Thank you for explanation. I’m a foreigner here and having hard time understanding different terms.
Thank you so much for this informative video. You explained so well and I am no longer confused. Thanks for making it so easy to understand.
What if for the entire year all you did was your annual physical which is considered a preventative care.
Does hat mean you will be required to pay the FULL deductible at the end of the year even though all you did that year was see ONE doctor for your annual physical?
Simple yet insightful explanation! Gratitude!
This guy Eric Hirschkorn is a hardworking fellow. I have known him for more than 30 years. He knows his insurance! I would buy from him.
Wow! What an amazing and easy to understand explanation. Wish I would have had those years ago. Thank you very much!
I hate our healthcare system
Any system that forcefully requires a middleman who profits from being a middleman. It is the difference between legitimately making money, and taking money. The reason everything cost so much for health "services" is precisely because of the Insurance system they propped up. You either pay them to be middlemen, or they will ruin you financially when you do need help.
I have an autoimmune disease that has no known cause or cure. My medication costs over 6k per month without insurance. My OOP max is $2800. So assuming the insurance holds true to that figure I have a $2800 annual fee for having a disease I didn't choose. Cool.
Knowing is power! my ER visit bills from CHI St.Luke's included charges for pain-relief injections never done, facility & procedures for Severity Level 4 and Level 5, while I spent total 3.5 hours sitting on a chair in their waiting room - (real severity - Level 2, as max) with some labs work and CT test performed and met the doctor at the very end - in 3+ hours after arrival... They say with straight face that extra & upcoded charges are correct - WATCH OUT FOR THAT!!! - you may need lawyers...
BTW: who has to check the charges levels: Me or Insurance co I pay monthly?
the only way I could have understood this was by this video thank you!
BEST EXPLANATION OUT THERE
Amazing explanation.
One thing you can be sure of: the insurance company will try to pass on as much cost to you as possible, all the while raising your premiums every year. Your copays go up, and your benefits will be less. That’s how the game works. They have the game set up in their favor. You can be sure of that.
I am learning so much from watching your videos. Thank you so much for sharing this amazing source of information. This one is quite helpful.
Is that deductible renewed or refreshed every year? I see some deductibles be at 7900$
Hi there! I could have sworn I’ve been to your videos before, but I realized it’s new to me after browsing through some of the published videos. Regardless, I’m definitely happy I stumbled upon it and I’ll be subscribing it and checking back frequently!
Wow
Its very simple informative video
Thank u
Baffled by premiums, deductibles and out-of-pocket maximums? NO, not really :-)
That is because I am Canadian! I am indeed very happy to be Canadian! Now that I am healthy, I pay more than I take out.. People that need care are taken care for free. I might one day need the same.. We take care of each other! Simple :-)
We have to pay for a huge military so we can murder people in other countries so we can't afford to take care of each other. :-(
you know in America people get so angry for such thing if it does exist in America such system .. there is always huge amount of hate against each other as people to people only .. but for the Gov senators and congress members who is getting all of it for free and for doing nothing !! OH its OK they are the Masters !! what a mentally amazing culture !!
saintⓋearth
East17A
You do not have as good as doctors, and the government determines who dies and who lives because you do not have enough people or resources. I do not have healthcare and I would rather keep it that way than have a single payer, because I am not stupid.
Finally I understand all about my insurance . Thank you.
The deductible is and copay is much higher than this. And if you reach your max out of pocket for the year, most like your premium will go up. Even worst they might choose not to insure you anymore. What’s more messed up is there are lots of fine prints when a insurer can actually not pay.
The NHS (National Health Service) in UK. Everyone working pays and puts a little bit in the pot for everyone including themselves. A lot less than the premiums and co-pays etc in these examples. (Which of course is the profit margin for the insurance companies.) That's it. Of course with mass immigration they are having to build more hospitals etc and there is waiting lists for certain non emergency things. But it's not about profit for health Insurance companies. It's about health for all from cradle to grave supported by each other. A form of 'socialism' despised in USA.
Insurance Companies are literally profiting off of us we need a fully covered Healthcare system.
This is very helpful and I now have a better understanding of how all this works, but I also have a better understanding of how stupid this system is.
This makes me want to cry. I will never not be in debt.
At least you don't have the complicated system we have in Canada where we go to the hospital and after extensive treatment, we leave and the biggest expense is the gift shop purchase of a box of chocolates!
Then comes all the paperwork.... what to do with the receipt for the box of chocolates?
Wow American health insurance is so sad! But great video
I think I will use this video as a starter to the discussion on health insurance and premiums, in my next lecture.
Thank you :)
- Prof Ghosh
This video should be played in schools!
WOW! This was SO CLEAR!
Well, my premium is just about the same amount as I'd pay out of pocket for my asthma medication. I might as well pay $320 a month to get the medication along with dental, vision, and preventative care visits. It's also nice to know that I won't go bankrupt if something bad happens and I end up in the hospital. Still, I envy Canadians.
Damn, it sucks to live in America. I mean it certainly beats a second or third world country, but we are like the bottom of the barrel of the first world countries.
So if a plan has 30% co-insurance, does that mean I pay 30% of a cost once I enter "stage 2?" for example $500*.3=$150, so I'd pay $150 for a $500 procedure/visit and the insurance pays the extra $350?
As a young adult, 20 in 4 months, i just lost passport and Anthem. I didnt understand how insurance really worked because it was through my parents. Now that im learning to individualize, i was lost. But still, i am not sure the smartest monthly insurance plan or company as a young adult making 9.25 an hour..
If you can't get health care through your employer, then you should qualify for subsidized health care. First find out if there is assistance from your state government. If not, then you should qualify for the PREMIUM TAX CREDIT (PTC), which is a type of federal subsidy available for people who make less than 400% of the federal poverty level (federal poverty level is currently about $12,140/yr for a single person, but higher in AK and HI). You can get the premium tax credit if you apply for a qualifying health care plan at the online marketplace (www.healthcare.gov). However, the enrollment period is in December of each year.
If you claim the PTC, then you will get a tax form 1095-A and you will have to submit a form 8962 when you file your federal income tax. Most of the numbers are on the 1095-A, so it's not difficult to fill out.
I claim the PTC because it's the only way I can afford health insurance at this time. I'm 54 years old, and my monthly premium is $793 (increasing yearly), but it's subsidized by the federal government.
You can get more information about the premium tax credit at the IRS web site or the online healthcare marketplace.
This is insanity. I wish we had Medicare for all or some version of it, just so we don't have to deal with the nightmare of insurance companies.
So I need to pay $8400 in medical bills AND my monthly premium BEFORE I get coverage??? I'm already paying $200 a month wtF???
I just learned this. I’m so pissed now. 😂 😂😂😂
Thanks so much for this video. If I understood correctly, here in Croatia we only pay premium and we are at the stage 3 from that very moment.
I literally can't even afford to just get a regular check up due to my deductable not being met lmao... Universal health care for America? Never.
This video stated you can get checkups with the premium? Why don't you look for something that will cover without needing to meet a deductible.
They should take the cutest cartoon shit out and explain plainly. NO ONE, ABSOLUTELY NO ONE IN THE US IS COMFORTABLE WITH THEIR INSURANCE. well rich people are, but everything is swell where money is no object
Very helpful!
BTW this is just for Medical Insurance. Dental is separate and it's payment structure is slightly different.
Vision is different too.
We kind of do what the US do. So here in Ireland, if you choose to go private instead of public, so if you have a pre-exsisting condition, depending on the plan you were on previously, you will or will not be covered. I was on my moms policy up until August 2021, then i went onto a new system. I only pay 68.88 euro a month which is about 70 some bucks a month. After that, they do the rest.
How about this. Our government says....As a law abiding citizen. If you’ll go out and get a steady job or jobs. Pay your taxes which keeps our economy flowing and running smoothly for 25 years. You will be rewarded for your dedication and hard work to our great country with absolute, top to bottom, everything covered healthcare?
STAY HEALTHY LOL
Thank you! Best video I’ve seen so far!
Just corporate welfare !!!
And the other kicker is that the american working class work so many hours it's impossible to get time to even go to the doctor, and the appointments are months out ,the irony of it all.
I'm making it a priority to see every dr and specialist. Work-life balance and selfcare is my number one priority for 2021
So what happens if your Deductible is $15,000, what if the year is over and you haven't paid that deductible do you have to start over next year SMH 🤦🤦
Technically not "every dollar" after the out of pocket maximum. It has to be THROUGH your insurance still, and you won't. So, for example, if it's through somewhere that your insurance doesn't cover, it won't count.
I’m still confused cause I don’t have bison insurance but want to get it with VSP. It says the copay would be $15 but when I called to a optometrist that also take VSP insurance, they told me it would $70. If I’ll end up paying more for an eye exam even with insurance, what am I doing paying for eye insurance in the first place since it not really saving me anything?
Here in New Zealand we have free universal public healthcare that cover most of our healthcare needs (such as treatment at public hospitals and prescription drugs covered by PHARMAC) but we do need private health insurance to cover things not covered by the public healthcare system (such as private hospital, drugs not covered by PHARMAC, mental health and dental).
I may buy supplementary private health insurance from NIB or Southern Cross.
I learned that In My Health class in 10th Grade that my Coach teacher discussed the PowerPoint of The notes which is have to be “ Insurance “
I'm finding several of my doctors are now charging annual fees too, so they can pay for litigation insurance, I'm assuming.