HOW DO HEALTH INSURANCE WORK

This video is about understanding health insurance costs. The video explains three main concepts: premiums, deductibles, and out-of-pocket maximums.

  • Premiums: This is the monthly fee you pay to your insurance company to have health insurance. It’s like a membership fee that allows you to access preventive care services for free, such as vaccines, screenings for diabetes, cholesterol and breast cancer.
  • Deductible: This is the amount of money you have to pay for your healthcare services before the insurance company starts to share the costs. Once you reach your deductible, you enter into the second stage.
  • Out-of-pocket maximum: This is the most you will pay for your healthcare expenses in a year. After you reach this amount, your insurance company will pay for everything else.

 

Here’s a breakdown of the stages you go through when using your health insurance:

  • Stage 1: You pay for most of your healthcare services until you reach your deductible.
  • Stage 2: Once you reach your deductible, you and your insurance company share the cost of your healthcare services. You typically pay a co-pay or co-insurance, and your insurance pays the rest. This continues until you reach your out-of-pocket maximum.
  • Stage 3: After you reach your out-of-pocket maximum, your insurance company pays for everything for the rest of the year.

 

In conclusion, the total cost of your health insurance will depend on the plan you choose, the care you need, and how much you are willing to pay upfront. You can get free help from a healthcare.gov assistant to choose the plan that’s right for you and your family.

 

 

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