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Great explanation. What I have always found confusing is insurance coverage for my semi-annual trips to my general practitioner. I usually only make a typical $40 “copay” while at the same I rarely meet my annual “deductible”. Payment against my “deductible” kicks in when I have an “event” like your ski accident or the burst appendix I had 8 years ago. So if I get this right, after I have shelled over enough money to reach my “deductible” then my insurance starts to cover a portion (not all) of my continuing costs until I hit my “out-of-pocket maximum”. The “portion” of my post-deductible costs that insurance covers is determined by the terms of my policy. Is that more-or-less correct?
Hi Joseph - Yes, you've understood the "deductible" and "out pocket maximum"! And also yes, it does depend on the terms of the health insurance policy, so you'll have to go through the fine print. Regarding your copay, that typically DOES NOT go towards your annual "deductible", but again FINE PRINT! Hope this was helpful.
It is interesting how many medical bills are incorrect. I had a screening exam and the pre-exam office visit was charged as an office visit when it should have been covered as a preventative visit - $133 saved.
Thank you so much! If for Americans this is a complex subject, can you imagine for a foreigner that has a public health system with no cost in his homeland? It's hard to understand all this terms and of course, why is so expensive?!?!?! Crazy!!
How is it possible to meet out of pocket max but not deductible? I've met my max but still owe $76.69 deductible. Now for a procedure I'm told I have to pay the $76.69
If my deductible is $0 but my out of pocket maximum is $2700 (includes deductible) what does that mean? Do I have to pay $2700 before the insurance pays?
If your deductible is $0, the insurance company starts paying whatever their designated % is from the very beginning. Here's more info on out-of-pocket max: www.healthcare.gov/glossary/out-of-pocket-maximum-limit/
Well, depending on the type of insurance you have, annual checkups and preventive care might be free or significantly less (e.g you might just have to pay a copay) even if you don’t meet the deductible - at least that‘s something. I always suggest calling your insurer to see what’s covered exactly!
@@DiamondNestEgg okay I will be applying to get benefits for the first time it’s a bit confusing tho, I’m trying to read through the book but I feel that I got some comprehension of it but not all… and yes preventative is 100% free it’s the other info on charts that’s a little confusing.. I do have the little booklet available, is it okay that if I send that over to you and maybe I could get educated about for a clearer understanding if that’s okay. I will still communicate with my insurance afterwards.
Thanks for visiting our personal finance channel! We hope this free content will help fast-track your financial journey! Please note that there are questions/ comments which I will not be able to answer without fully understanding your financial, personal & other circumstances. Everyone's financial journey is different. If you wish to set up a consultation call & discuss whether we can help you on an individual basis, please complete the Work With Us form on our website: www.diamondnestegg.com
🎯 GRAB YOUR FREE FINANCIAL GOAL SETTING & BUDGETING TEMPLATE!
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Good information. Is drug proscription part of deductibles?
Swedish
Very good, informational content. Thanks for sharing!
Great explanation. What I have always found confusing is insurance coverage for my semi-annual trips to my general practitioner. I usually only make a typical $40 “copay” while at the same I rarely meet my annual “deductible”.
Payment against my “deductible” kicks in when I have an “event” like your ski accident or the burst appendix I had 8 years ago.
So if I get this right, after I have shelled over enough money to reach my “deductible” then my insurance starts to cover a portion (not all) of my continuing costs until I hit my “out-of-pocket maximum”.
The “portion” of my post-deductible costs that insurance covers is determined by the terms of my policy.
Is that more-or-less correct?
Hi Joseph - Yes, you've understood the "deductible" and "out pocket maximum"! And also yes, it does depend on the terms of the health insurance policy, so you'll have to go through the fine print. Regarding your copay, that typically DOES NOT go towards your annual "deductible", but again FINE PRINT! Hope this was helpful.
Thank you so much, big help for me. 😊
It is interesting how many medical bills are incorrect. I had a screening exam and the pre-exam office visit was charged as an office visit when it should have been covered as a preventative visit - $133 saved.
Awesome. Thanks for simplifying these complex health plans.
Thank you so much! If for Americans this is a complex subject, can you imagine for a foreigner that has a public health system with no cost in his homeland? It's hard to understand all this terms and of course, why is so expensive?!?!?! Crazy!!
This was the best explanation esp helpful were the examples on what we spend on to meet the deductible. Thank you!
Your welcome Andrea - glad I was able to help & happy new year!
@@DiamondNestEgg Yes! Happy New Year and thank you so much again! 😊
How is it possible to meet out of pocket max but not deductible? I've met my max but still owe $76.69 deductible. Now for a procedure I'm told I have to pay the $76.69
Thank you so much. Your video really simplified these confusing options and made it much clearer.
Currently working in benefits and using this as a guide - thank you!
You’re welcome - thanks for dropping by!
very simply explained!Thanks
Your welcome!
If my deductible is $0 but my out of pocket maximum is $2700 (includes deductible) what does that mean? Do I have to pay $2700 before the insurance pays?
If your deductible is $0, the insurance company starts paying whatever their designated % is from the very beginning. Here's more info on out-of-pocket max: www.healthcare.gov/glossary/out-of-pocket-maximum-limit/
You did a wonderful job explaining
So basically if I don’t meet the deductible it’s 100% on me?
Unfortunately yes
@@DiamondNestEgg then it’s useless lol …
Well, depending on the type of insurance you have, annual checkups and preventive care might be free or significantly less (e.g you might just have to pay a copay) even if you don’t meet the deductible - at least that‘s something. I always suggest calling your insurer to see what’s covered exactly!
@@DiamondNestEgg okay I will be applying to get benefits for the first time it’s a bit confusing tho, I’m trying to read through the book but I feel that I got some comprehension of it but not all… and yes preventative is 100% free it’s the other info on charts that’s a little confusing.. I do have the little booklet available, is it okay that if I send that over to you and maybe I could get educated about for a clearer understanding if that’s okay. I will still communicate with my insurance afterwards.
Send it over to jennifer@diamondnestegg.com and we’ll see if we can help
I am trying to pick plan but still confused should deductible be higher than out of pocket
Your deductible is a part of your out of pocket expenses
Thanks!
Can you please help me understand and decide between two health insurance options offered by my job?
This video should provide additional info: Health Insurance Basics | PPO vs EPO vs HMO
th-cam.com/video/t6ZXFuriH0E/w-d-xo.html
And this one as well: High Deductible Health Plan vs PPO | WHICH SHOULD YOU CHOOSE
th-cam.com/video/c2XPEwkSK7o/w-d-xo.html