Why Is Health Insurance so Complicated

Americans carry many different forms of insurance. Theres car insurance, home insurance, life
insurance, even pet insurance . . .

Most of these insurance policies work well and are
fairly priced. But there is one glaring exception: health
insurance. Only health insurance becomes more complicated
and more expensive at the same time. So, the obvious question is: why? To answer this question, we have to start
at the beginning.

What is insurance? Its pretty straight-forward: You pay a
monthly fee which provides financial protection against unforeseen, sometimes catastrophic,
events. People buy homeowners insurance, for example,
to protect themselves from the financial loss incurred in the event of a fire, a flood or
theft. Because millions of people are paying into
the insurance pool, the pool has enough money to cover the unlucky person whose house does
burn down. And since insurance is meant to share risk,
it only stands to reason that higher-risk individuals have to pay more to be insured.

Someone who has had two accidents is going
to pay more for car insurance than someone who has never had an accident. Why? Because their track record indicates they
are more likely to have another accident. But while insurance provides a bulwark against
unforeseen loss, it does not protect against routine expenses. Car insurance protects you in the event that
you wind up in a car wreck or your vehicle is stolen, but it doesnt cover routine
maintenance like oil changes, replacing brake pads or tire erosion.

Why? Because everyone needs routine oil changes,
new brake pads, and new tires. So, there is no risk to protect against. Health insurance in America works very differently. Many of us have health insurance plans that
arent insurance at all.

Theyre really pre-paid health care plans. They cover routine check-ups, less serious
illnesses, and recurring expenses like prescription medications in addition to protecting you
from a health disaster. All of this has made healthcare much more
expensive and complex than any other form of insurance. That is true whether you get your insurance
through your employer, through the government, or if you pay for your own plan.

The Affordable Care Act, known as Obamacare,
was passed on the promise that it would fix these issues and bring down healthcare costs. But it has actually made the problem much
worse. First, it limited the variety of health insurance
plans private companies could offer. It did this by mandating that every plan had
to cover the same set of ten health benefits, including preventive care, maternity care,
mental health care, and contraception.

Second, Obamacare prevented insurers from
charging premiums based on the risk they were assuming. A person with a much higher risk of getting
sick couldnt be charged more than a person with a much lower chance. These two aspects of Obamacare  requiring
all policies to have certain coverages and not allowing insurance companies to charge
more for riskier clients  caused the price of insurance to rise dramatically. In Arizona, for example, the price more than
doubled between 2016 and 2017 alone.

So, how do we undo this mess? By making health insurance more like, well,
insurance. First, stop making people buy plans that include
things they wont use and dont want. Second, allow health insurers to offer more
options at different prices. Do these two things and youd make health
insurance a lot more affordable for a lot more people.

And what about people with pre-existing conditions
for whom every insurance plan is just too expensive? We do what any compassionate society does:
we make sure they get the medical care they need. But we dont need to upset the whole concept
of insurance and make healthcare more expensive for everyone else to do it. Most Americans want to do the responsible
thing and insure themselves against catastrophic health care emergencies. But with health insurance costs rising every
year, being responsible is becoming more difficult.

Im Lanhee Chen, research fellow at the
Hoover Institution, for Prager University..

Why do you need health insurance

They say health is wealth. Unfortunately, this holds true when you fall ill as well! When that happens... ...You realise the fact... ...That your coverage is really inadequate!!! Sub-limits only partially fund your treatement or prevent you from choosing the facility you want If that isn't bad enough...

You realise you've used up the complete limits in one round of hospitalisation! Leaving no room for more! To add insult to injury medical costs have risen fast like real estate prices making your current insurance policy quite inadequate! Your heart is beating faster already!!! But hold on... It's not all that bad! We know there are many confusing questions How expensive is medical treatment in my city? Is the insurance provided by my employer sufficient? Should I insure every family member individually... ... Or should I go for a common policy cover? Will my existing health problems be covered? The worst thing you can do is compromise on your medical treatment tomorrow, because you are simply not bothered today! A small premium every month could save you a fortune...

... When emergency strikes! Our well researched tools, blog posts and videos help you navigate this decisions. You'll find it's truly healthy knowledge!.

Why Are People with Health Insurance Going Bankrupt

PAUL JAY: Welcome to The Real News Network.
I'm Paul Jay in Baltimore. We're now into the beginnings of the implementation
of what everybody, including President Obama, is calling Obamacare. So now we have a little
better idea of what it is and how it might work. Now joining us to talk about it are two critics
of Obamacare.

First of all, Kevin Zeese is codirector of It's Our Economy, an organization
that advocates for democratizing the economy. And also joining us is Dr. Margaret Flowers.
She's a pediatrician from Baltimore who advocates for a national single-payer health care system,
or Medicare for all. Thanks for joining us.

MARGARET FLOWERS: Thank you for having us. JAY: So tell us now. You have been critical
about this from the beginning. You were for single-payer during the health-care debate.
But now it's passed.

It's starting to be implemented. You have a better idea what it is. So how's
it looking? FLOWERS: Right. Well, it's looking pretty
much like what we expected.

Right now the United States is the only industrialized wealthy
nation that has a market-based health care system, and the Affordable Care Act moved
us further in the direction of a market-based health care system by requiring people who
don't qualify for the public programs to purchase private health insurance. That will be going
into effect. The exchanges where people will buy that insurance roll out in October of
this year. By January 2014, people have to have insurance or face a penalty.

But what we're seeing in terms of the type
of insurance that people are going to be offered and the trends of what people are actually
purchasing right now is we're moving more in the direction of what we call underinsurance,
where people may have an insurance plan, but there are significant financial barriers to
getting actual care and significant financial risks if someone has a serious accident or
illness. JAY: [crosstalk] FLOWERS: Well, what we see, it's interesting.
Over the last three years there's been a slowing in the rate of rise of our health-care spending
in this country, and it was interesting 'cause the president said in his State of the Union
address, oh, the Affordable Care Act is already working; we're seeing our costs slowing. But
the actual data shows that our costs are slowing because people are using less health services.
The copays and the deductibles that they face mean that they don't have the cash in their
hand to go and get those health-care services. And then what we're seeing in terms of bankruptcy--and
this is actually based on a study done before the economic crash, based on 2007 data--was
that 62 percent of our personal bankruptcies were due to medical costs and illness.

Almost
80 percent of those patients had some form of health insurance. If we look at Massachusetts,
that's had the same kind of legislation on the state level, the number of medical bankruptcies
there is actually rising. JAY: So why is that? If you have health insurance,
why are you going bankrupt? FLOWERS: Because they don't cover--well, they
have co-insurances, so at some level, you know, they cover up to this level, but after
that, your co-insurance is 20 percent, so you have to pay for 20 percent of the services.
They can say that services are uncovered services, and so then you're liable for those. They
can restrict the networks.

So an interesting--out in California, Blue
Cross Blue Shield out there, that covers the largest number of public employees, dropped
Cedars-Sinai and UCLA from their network because that's where people go when they need actual
health care. So if you have a serious problem and that's the place that can treat you, you're
going to have to hold a bake sale or sell your home or do something so that you can
afford that care. KEVIN ZEESE: And Obamacare's going to make
this worse, because what Obamacare does is, you know, there's several levels of insurance
coverage--90/10, where the insurance company pays 90 percent, consumer pays 10 percent;
80/20; 70/30; 60/40. The subsidy provided by Obamacare to people who can't afford insurance
will only cover 70/30 plans.

So when you get a serious illness, you're paying 30 percent
of the cost of that health care. Now, what's really bad about this is that
prior to Obamacare, some of the state insurance regulators were pushing insurance coverers
to a higher level, where they would provide more coverage rather than less. Obamacare
has now put it into law that 60/40 is okay and 70/30 is what the government will pay
for. And so the 80/20 and 90/10's become less common.

So you're going to see more and more
people with underinsurance and not going to see lack of insurance completely go away. In Massachusetts, which is basically the pilot
program for Obamacare--Romneycare was the pilot for Obamacare (it's pretty much the
same plan)--what you see up there is only about half of those people who are without
insurance got covered by Romneycare. The same is going to happen here. The Congressional
Budget Office is estimating 30 million or more people will have no insurance when Obamacare
is fully implemented.

But those who have insurance are going to now be coming with underinsurance. JAY: And this is all kind of new to me. I
mean, viewers of The Real News probably know I'm a dual citizen and I was in Canada until
recently, and we don't have any of this, right? It's single, you know--. ZEESE: You have a sensible program.

JAY: You have a government health-care plan,
and when you're born you get a health card, you show it, and that's kind of the end of
it. So now that I--I have not seen this before. The insurance I have down here now, I have
a copay, but there's--I think it's, like, a $3,000 cap. After that, the insurance pays
100 percent.

FLOWERS: Of covered services. If they say
something's not covered--. JAY: Okay. But are you saying that some of
this, that copay does not have a cap? FLOWERS: It's not that the copay doesn't have
a cap.

It's what the insurance companies are able to determine. You know, they'll say that
something is not covered, that it's experimental. Or we see this all the time, where they actually
charge people for things that are in their plan that they shouldn't be paying for. And
if you're not savvy enough to understand that your plan covers that service and then fight
for it--.

[Snip] before 2005, I think, looking at our
Blue Cross program here. And what they found was that about one out of every five claims
was denied just randomly. Like, if five claims come in, they just pull one out and say, we're
not paying this one. And it wasn't based on any rationality.

It was just a way of, you
know, being able to get more money. And we have evidence of this in New York from
people that worked in these claims offices that if there was a certain level area of
the city, lower-income area, they would deny those claims because they knew people didn't
have the resources to fight back. JAY: [crosstalk] go back to my example, we
had--I think it's an 80/20. So our copay-- ZEESE: That's good coverage in the United
States.

JAY: --wasn't so terrible. But, I mean, the
final bill had to be in the realm of close to $300,000. If it had been a 60/40, we would
have been toast. FLOWERS: Yeah.

Yeah. ZEESE: Exactly right. FLOWERS: And the other thing with that is
if your babies were born in December and you met that whole, you know, what your out-of-pocket
costs were in December and January, you start all over again. And that's where some families
just can't handle that.

ZEESE: And that's what they're finding in
Massachusetts is they're finding that with Romneycare, which was, as I said, the pilot
program for Obamacare, they're seeing that people are not going to get health care when
they need it, because they know when they go it's coming out of their pocket. And that's
not a good thing. When you put off the necessary health care, what that results in is a bigger
bill later. You know, if someone's having a problem--.

FLOWERS: Or a worse outcome. ZEESE: Or a worse outcome, or, yeah, you--. FLOWERS: You can't work 'cause you're disabled
now. ZEESE: Yeah.

So it gets more costly by not
taking care of the problem at the initial stage. You let it grow and get bigger until
you have no choice but to face it. And so in Massachusetts they're finding bankruptcies
are continuing at the same level. They're finding only half the people that were uncovered
are now covered.

And they're finding those who are covered are not getting health care
that they need. That's not the kind of health-care system we should have in the United States. FLOWERS: Costs are rising. ZEESE: It's not appropriate.

JAY: So where are we at with this, then, in
terms of the politics of this? Is there any chance this debate gets reopened in the next
two, three years? FLOWERS: That's really up to the people, whether
we force it to be opened or not. I mean, it's interesting right now that you
have, you know, more kind of these articles coming out in Time magazine looking at our
health-care system. And I'm not really sure what's behind that right now, unless they're
trying to maybe win the argument by creating it early and, you know, not allowing us to
make that argument. But I think what we're going to see over the
next couple of years is we're going to see continued rise in our health-care costs, continued
poor outcomes, families continuing to face financial barriers to care and bankruptcy.
And it's up to us to start saying that, you know, these things are not okay and that there
is a real solution.

We'd like to join the rest of the civilized world and have a publicly
financed health care system. ZEESE: And just to answer your question a
little more, there are people in the country who are working on this. FLOWERS: Absolutely. ZEESE: There are.

And more and more people
are looking at it through the prism of human rights. Health care is a human right. It's
not a commodity. We don't want Wall Street health care.

We want a human right-based health
care. And there are local--there's a Maryland health care human rights campaign. There's--Vermont
has one. Oregon.

They're in Washington. They're all--coming up all over he country, 'cause
people who are looking at how Obamacare is so far being implemented are seeing premiums
rise, health-care use going down. They're seeing more problems and they're seeing what
happened in Massachusetts. And so people who are aware are organized and getting more organized.
So there's ways to get involved in this and reopen this debate.

JAY: And are there--given how paralyzed national
national politics is on this issue, are there some local examples of where there are some
other alternatives? I know in--San Francisco, I believe, has essentially a single-payer--. ZEESE: They have a restaurant tax-- FLOWERS: Right, a restaurant tax that pays
for that. Yeah. ZEESE: --that pays for health care for people
in San Francisco.

Vermont has pushed as far as you can, so far, toward a single-payer
system. They have a number of steps to get there, but they have a good grassroots campaign
that's continuing to push. JAY: So there may be some initiatives at a
municipal/state level that might make some breakthroughs here. FLOWERS: Right.

ZEESE: But this needs to be a national solution.
I mean, really you want to be able to travel throughout the United States and have health-care
coverage. JAY: Yeah. In San Francisco, you just leave
the city and you've lost your coverage. ZEESE: That's what I mean.

FLOWERS: Right. And also, you know, the thing
that I often point out is that the United States is already spending more than enough
for a universal, comprehensive, high-quality health-care system. We spend two and a half
times what the average OECD nation, you know, industrialized nation spends per person on
health care. So we have the money to do this and we have the resources to do this, and
it's really just up to us to demand that we have the kind of health-care system that we
need.

And you can't get the cost--that was my point was that you can't get the real cost
savings unless you do this at a national level. ZEESE: What I was laughing about was I was
thinking about Congress [incompr.] All this craziness about deficit. Health care's 18
percent of our GDP and going up, and you're not going to solve the deficit for the long
term without solving health care. And that's not Medicare that's the problem.
That's not Medicaid.

The problem is the big part of the system, which is the market-based
system. Paul Ryan, in his idiocy, pushing toward privatization
of Medicare, why he thinks having an insurance company making profit off of elderly people
in their health care is going to lower costs is just absurd. It makes no sense. But that's
the state of the Congress.

And, you know, Obama's even talking about
reforms of Medicare that'll make it weaker, in my view. He's done some good things [crosstalk]
Medicare Advantage. It was a good move. That's a--Medicare Advantage is a nice name for private
insurance, which was ripping off elderly people is what it was really doing.

It was not a
good part of the elderly health care in our country. So he did some good things on challenging
that. But what we're seeing in Congress is no sensible
discussion on this issue. We're seeing them push in the wrong direction toward more privatization,
more cost, higher percentage of our GDP, and more deficit, and less health care for American
people.

FLOWERS: But the answer is simple, and as
long as the people understand what it is that we require and we don't settle for anything
less,-- JAY: Which is Medicare for all. FLOWERS: --which is Medicare for all, then
we can push in that direction and do it. JAY: Alright. Okay.

Thanks for joining us,
Margaret, Kevin. FLOWERS: Thank you. ZEESE: Thank you. JAY: And thank you for joining us on The Real
News Network..

Why Are American Health Care Costs So High

Good morning Hank, it's Tuesday. I want to
talk today about why healthcare costs in the United States are so phenomenally, fascinatingly
expensive, but first I have to blow your mind: Alright, so you've probably heard that the
reason that people enjoy "free" healthcare in Australia and the UK and Canada, etc, etc
is that they pay higher taxes. That money then goes into a big pot and is used to pay
for people's healthcare, but in fact, in the US, we spend more tax money per capita on
healthcare than Germany, Australia, the UK, or Canada. That's right Hank: you pay more in taxes for
healthcare than you would if you were British, and in exchange for those taxes, you get no
healthcare.

In fact, only about 28% of Americans get their
health insurance through government funded programs, mostly poor people, old people,
and Congresspeople. But as you can see in this graph our private healthcare spending
(most Americans are privately insured through their employers) is WAY higher than anywhere
else in the world. In total, the US currently spends about 18% of its gross
domestic product on healthcare costs. Australia by comparison? 9%.

Why is this? Well because everything costs
more, which seems obvious, but apparently isn't, because every article you read is like
"Oh it's because of malpractice insurance" or "it's because we're obese" or we go to
the doctor too much or people are prescribed too many medications. Well, not really. It's because everything costs more. A hip
replacement in Belgium costs $13,000.

In the US it's often over $100,000. Colonoscopies
average over $1100 a piece in the US; in Switzerland they're $655. And on average a month of the
drug Lipitor will cost you $124 if you live in the US. If you live in New Zealand? $7.

Now we are alsonot to bragricher than
all of these countries, so it makes sense that we should spend a little more on healthcare.
But we don't spend a little more. We spend a ton more. And vitally, we don't get anything
for that money, which means we are essentially paying people to dig holes and then fill those
holes back up. Like we don't live longerin fact we're 33rd in life expectancyand in
everything from asthma to cancer, according to one recent nonpartisan study, American healthcare
outcomes are "not notably superior." So why are we spending all of this money for
nothing? Well first, let's discuss some of the problems that are not actually problems.

For instance, the problem is not so-called
"overutilization:" the idea that Americans go to the doctor more and get more tests and
spend more time in hospitals. We know this because Americans actually go to the doctor
less than Europeans and spend much less time in hospitals, although to be fair, you can
stay in a Dutch hospital for seven nights for what it costs to stay in an American hospital
for one night, so no wonder we're hesitant. Also it is not because we're sicker than other
people. Everyone likes to blame obesity on our rising healthcare costs, but yeah, no.
That argument is just not supported by data.

For one thing, disease prevalence does not
affect healthcare costs that much. And for another thing, while we do have more obesity
in the United States, which sometimes leads to health problems, we have fewer smokers
and less alcohol consumption (really? Apparently yes). So that saves us a little money, and
if you compare us to like the British or the French, in the end it's probably a wash. Hank, the truth, as usual, is complex.

Like,
there are obvious inefficiencies in our healthcare system. For instance, not everyone has insurance.
If you don't have insurance, you still get healthcare, but you're responsible for paying
for that healthcare, which often you can't do, so you end up going bankrupt. That sucks
for you, obviously, because you're bankrupt, but it also sucks for the rest of us because
we have to pay not only for your care, but also for all the money the hospital spent
trying to get you to pay for your care. Also the only options available to uninsured people
are usually the most expensive options, like emergency rooms, which is just BANANAS.

But those
inefficiencies are hard to measure. Fortunately, there are things we can measure. So like I said before, because the US is one
of the richest countries in the world, you would expect us to pay a little more for healthcare
than most people. The question is, when do we pay MORE than you would expect us to pay,
and that turns out to be pretty interesting.

Let's start with malpractice and so-called
"defensive medicine." The idea here is that doctors are scared of huge malpractice suits
so they order a lot of unnecessary tests in order to, like, cover their butts. That
does contribute to our healthcare costs, like there are more MRI and CT scans in the US
than anywhere else. However, there are a bunch of states like Texas that have passed tort
reform to limit malpractice suits, and in those states healthcare costs have dropped
by an average of a whopping 0.1%. The biggest estimates for the total costs of defensive
medicine put it at around 55 billion dollars, which is a lot of money, but only 2% of our total
healthcare costs.

Another smallish factor: doctors (and to a
lesser extent, nurses) are paid more in the US than they are in other countries, and by
my possibly-faulty math we end up spending about 75 billion dollars more than you would
expect us to there. And then we have the cost of insurance and
administration costs, like paperwork and marketing and negotiating prices. That's about 90 billion
dollars more than you would expect us to spend. We spend about $100 billion more than you
would expect on drugs, not so much because we take MORE of them, but because the ones
we take cost more per pill.

Okay, and now for the big one. I'm gonna lump
inpatient and outpatient care together, because in the US we do a lot of things as outpatient
procedures, like gallbladder surgeries, that are often inpatient procedures in other hospitals.
We're just gonna make a big ball [gestures]. That big ball is $500 billion more than what
you would expect given the size of our economy. Per year.

Why? Because in the United States we do not negotiate
as aggressively as other countries do with healthcare providers and drug manufacturers
and medical device makers. So like in the UK the government goes out to all the people
who make artificial hips and says "One of you is going to get to make a crapton of fake
hips for everybody who is covered by the NHS. Here in the United Kingdom. But you better
make sure your hips are safe, and you better make sure that they are cheap, because otherwise
we're going to give our business to a different company." And then all the fake hip companies
are motivated to offer really low prices because it's a really huge contract.

Like think if
your company got to put hips inside of everyone in England and Scotland and Wales
and Northern Ireland (I guess not everyone. Just the people who need hips). But in the US we don't have any of that centralized
negotiation, so we don't have as much leverage. The only big exception is Medicare, the government-funded
healthcare for old people, which, not coincidentally, always gets the lowest prices.

So basically, Hank, in the United States,
providers charge whatever they think they can get away with, and they can get away with
a lot, because it's really difficult to put a price on, like, not dying. This is a phenomenon
called "inelastic demand," like if you tell me that this drug will save my life costs
$7 a month, I will pay you $7 a month for it. If you tell me that it costs $124 a month,
I will find a way to find $124 a month to pay for it. You can't negotiate effectively
on your own behalf for healthcare services because you NEED them.

And not like you need
a Macbook Air or the new season of Sherlock, but actual, physical need (I guess it is like
the new season of Sherlock). So basically, Hank, until and unless we can
negotiate as effectively with the people providing healthcare as Australians and British people
do, US healthcare costs will continue to rise faster than anywhere else in the world and
we WON'T get better healthcare outcomes. Hank, I know this video is long, although
it could have been much longer, but I am so tired of people offering up simple explanations
for what's wrong with our healthcare system. They say "Oh, it's malpractice," or "it's
doctors who must also be businesspeople" or "it's insurance companies" or "it's insane
rules for who can GET insurance." It's drug companies, it's government bureaucracy, it's
an inability to negotiate prices.

Yes, yes, yes, yes, and YES! It is all of those things
and more! It is not a simple problem, there will not be a simple solution, but it is probably
the biggest single drag on the American economy and it's vital that we grapple with it meaningfully
instead of just treating healthcare costs as political theatre. So I hope I've at least introduced the complexity
of the problem. I've put some thoroughly nonpartisan links in the doobly-doo for further reading.
Hank, welcome back to the United States. As you can see, everything is peachy here.

I'll
see you on Friday. Friendly reminder, educational videos are allowed to be more than four minutes long. All of the people who are commenting about how punished I am did not watch to the end of the video.
I feel dizzy..

Where Can I Get Affordable Health Insurance if I Have Diabetes

Hello, I am Ty Mason of thediabetescouncil.Com,
researcher, writer and I have type 2 diabetes. I want to emphasize that my perspective is
coming from one with Type 2 and not Type 1. Our channel is primarily for those with Type
2 Diabetes and PreDiabetes. Today I want to talk about health insurance
for those with diabetes.

After you watch the video today, I invite
you check out the description box for my new ebook. This is one of the most comprehensive diabetes
meal planning book you can find. It contains diabetes friendly meals/recipes,
recipes for different goals such as 800-1800 calories per day meal plan, diabetes meal
planning tips and tricks. There are also tons of diabetes friendly recipes
for everyone! Diabetes is primarily a self-managed disease.

In order to stay healthy, a person with diabetes
needs supplies like test strips, meters and insulin. Adequate and affordable health insurance is
important for people with diabetes to help them access the supplies, medications, education
and health care to manage their diabetes and prevent, or treat, complications. In the past, obtaining health insurance could
be difficult for people with diabetes, however recent reforms improve access to coverage. The 2010 Affordable Care Act was passed in
hopes it would give more Americans access to better health insurance at a reasonable
price.

As of the date of this video, the law is collapsing
with many insurers dropping out of the exchange leaving many with no real choice for health
insurance. The Obama Care is currently in the process
of being repealed and replaced by the new administration. I say this, not as a political statement,
but to say this is a fluid situation and the information I give to you from my research
is subject to change very quickly. Depending on the state in which you live and
the where in that state, you have the ability to purchase health insurance regardless of
the fact that you diabetes.

For many this is the most affordable option. However, some with diabetes may also qualify
for government assistance programs such as MediCare of MediCaid. My first suggestion would be for you to visit
your local social security office or visit medicare.Org
Many pharmaceutical companies also offer help on medications through discount prescription
plans that are often free of charge. If you do not qualify for government assistance,
your best option is to visit your states insurance exchange website.

This is usually found at your states insurance
dept website. You can also google your states insurance
exchange website. I know I am assuming that those of you watching
are residents of the US, other countries have different methods of insurance including government
run insurance. Health Insurance is a big topic these days.

It is sad that some people have to choose
between needed medication and making a car payment. At times, it seems the insurance premiums
cost more than the benefits. I feel your pain if you have to make those
tough decisions. I encourage you to seek out help from the
makers of your medications or testing supplies.

Quite often they can be very helpful. Dont forget to get my new ebook and please,
subscribe to our channel for many more videos like this one in the future. Thanks for watching. I am Ty Mason..

What does the EPO, PPO, HMO, POS stand for in HEALTH INSURANCE What is network provider

Welcome back to my channel Lets Talk Money. Today I would like to explain the network
types most commonly known as EPOs, PPOs, HMOs and POS plans. Some plan types allow you to use almost any
doctor or health care facility. Others limit your choices or charge you more
if you use providers outside their network.

You can easily identify the type of plan by
looking at the description next to the plan name. Lets look at each network type.  Preferred Provider Organization (PPO):
PPOs give you the choice of getting care from innetwork or out-of-network providers. You pay less if you use providers that belong
to the plans network.

Youll pay more if you use doctors, providers,
and hospitals outside of the network, and you may have higher out-of-pocket costs for
services. If you have a PPO plan, you can visit any
doctor without getting  a referral.  Exclusive Provider Organization (EPO):
A managed care plan where services are covered only if you use doctors, specialists, or hospitals
in the plans network (except in an emergency). No referral is required to see a specialist  
Point of Service (POS): A type of plan where you pay less if you use doctors, hospitals,
and other health care providers that belong to the plans network.

POS plans require you to get a referral from
your primary care doctor in order to see  a specialist.  Health Maintenance Organization (HMO):
A type of health insurance plan that usually limits coverage to care from doctors who work
for or contract with the HMO. An HMO generally wont cover or has limited
coverage for out-of-network care except in an emergency. If you use a doctor or facility that isnt
in the HMOs network, you may have to pay the full cost of the services you get.

HMO members usually have a primary care doctor
and must get referrals to see specialists. Weve been talking so much about provider
networks, SO what is that? Well, a provider network is a list of the
doctors, other health care providers, and hospitals that a plan has contracted with
to provide medical care to its members. These providers are called network providers
or in-network providers. A provider that hasnt contracted with the
plan is called an out-of-network provider.

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Young Adults Need Affordable Health Insurance

Young Adults Need Affordable Health Insurance

As graduates around the country are getting organized for new adventures and every day jobs, the importance of cut priced wellbeing coverage is beginning as much as be a fact. In a model new ballot  published by UnitedHealth Group, Inc, over 2/three of young adults throughout the US comprehend they desire cut priced clinical coverage, on the other hand over 1/2 of them say they might still now not have the recommendation they desire to settle on the suitable classification of preservation to satisfy their calls for.

1,000 young adults have been polled and sixty seven% of them haven't made any plans for clinical coverage. While these 18 - 21 year olds comprehend they desire coverage preservation, they is now not infrequently always fresh involving the preservation they have got thru their parents and do now not even comprehend when that preservation will end.

Young adults are throughout the fantastic and quickest increasing close by of the 46 million uninsured individuals throughout the US. This alarmingly big close by of Americans, alongside with the 25 million underinsured, goes thru brilliant opportunity by now not having related preservation throughout the case of a clinical desire.

When you would like cut priced wellbeing coverage and that you just'll now not get preservation thru your employer, it is able to also be now not clean how that you just'll even start the manner of locating preservation on your personal.

Determine your coverage calls for: Before that you just'll became conscious of the least costly clinical coverage, you would like to appreciate how coverage guidelines work. When it involves price, there are two concerns to perceive -the deductible and the co-pay. Nearly all coverage policy have each and every a deductible and co-pay you are guilty to pay.

The deductible is the quantity of clinical expenditures you'll have to pay out of pocket earlier your coverage preservation kicks in. The co-pay is the portion of every and every certain user price you will have got to pay, with the exception of the coverage market's portion. For event, whilst you've a $500 deductible, you are guilty to pay the first $500 of clinical expenditures in step with year, earlier your coverage market pays irrespective of what element. With the co-pay, you will have got to pay a proportion of every and every price, aas a rule at the time of your carrier.

To lend a hand shield your wellbeing coverage cut priced, you will have possibilities how you pay these expenditures. If you are in kind of splendid wellbeing, settle on a cut deductible and stronger co-value. If even when, you go to the in style practitioner incredibly aas a rule, you pay be stronger off with cut co-funds, on the other hand an elevated deductible. Once your annual deductible is reached, you'll have a lot less expense thru out the year. For the least costly wellbeing coverage top rate, settle on each and every larger deductibles and stronger co-funds. This will now not a lot slash than spread your rates out over a duration of time.

You can take monitor quotes and plans for clinical coverage on-line. This manner that you just'll glance at a vary of categories of guidelines from multiple corporations and take your time locating out the gold intensive-spread multiple to your clinical coverage calls for.

It is especially imperative for young adults to have a favorable realizing of the classification of coverage they desire. With the vast diversity of wellbeing coverage corporations, at the part of the style in guidelines and preservation, the principle straightforward manner to became conscious of the least costly wellbeing care preservation is to operate a little study and take monitor your possibilities. Most importantly, even when, is to circumvent going with non wellbeing coverage at all so that you just do now not became conscious of yourself with big expenditures that you just'll now not manage to pay for to pay.