How to compare and buy health insurance plans? What are the benefits and coverage?
Table of Contents
- Welcome back to my channel let's talk money today I will be addressing a very...
- And your plan share the cost plan categories have nothing to do with the...
- This type of plan let's talk about bronze blends now this...
- To any deductible white corner is subject to a deductible after the first...
- Look at the silver plan the silver plan has a lower deductible there are no...
- May be a good choice for you on the other hand let's say you know you have a...
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welcome back to my channel let's talk
money today I will be addressing a very
important question and that is how to
compare and select health insurance plan
this is the most common question I get
as an insurance agent and it's my job to
help you in this video I will share all
you need to know in order to make an
educated decision while shopping for
healthy transplants I will also give
valuable tips so keep watching until the
end you can also refer to other videos
that I recently posted for example in
00:30
one of the videos I explained the
difference of Evo PPO HMO and POS plans
by known these things you will be able
to navigate and compare plans with
confidence again please watch this video
until the end as I will give away free
tips and tricks that will help you
choose a health plan and save money okay
so let's start with the basic basics
there are four categories of health
insurance plans bronze silver gold and
platinum this categories show how you
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and your plan share the cost plan
categories have nothing to do with the
quality of care there is also a
catastrophic plan for those that qualify
and it's usually for those who are under
the age of 30 each level pays a
different portion of your healthcare
bills grouping plans this way makes it
easier to shop for insurance for example
the top-of-the-line plan is platinum it
pays the highest portion of your
healthcare bill it also cost the most
the basic plan is bronze it pays an
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average of 60% of your healthcare bills
and cost the least let's start with the
catastrophic plans this is a minimum
coverage plan for those who qualify if
you are under age of 30 you may be able
to buy an additional health insurance
plan option called minimum coverage plan
these plans usually have lower premiums
and mostly protect you from West's
worst-case scenarios there is the one
very important thing that many consumers
do not know and end up overpaying for
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their health insurance those who have
minimum coverage plans do not qualify to
receive premium assistance also known as
advanced premium tax credits
minimum coverage plans usually cover
three doctor visits of urgent care
visits with no out-of-pocket costs and
pre preventative benefits all other
services will be full price but at the
negotiated in network price until you
reach the out-of-pocket maximum here are
a few reasons why you might consider
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this type of plan
let's talk about bronze blends now this
are usually the high deductible plans on
average your health plan pays 60% of
your medical expenses and you pay 40% I
will go over the details for these plans
shortly silver plans are the most
popular ones on the market so far on
average your health plan pays 70% of
your medical expenses and pay 30% in
some cases individuals may qualify for
an enhanced silver plan this means that
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when they choose a silver plan they have
based on their income enhanced
out-of-pocket savings to lower co-pays
coinsurance and deductibles individuals
and the savings categories get the
benefits of a gold or platinum plan for
the price of a silver plan this plans
are only available on the exchanges feel
free to reach me and I'll help you
understand if you qualify for enhanced
silver plans let's look at the gold plan
now gold plans on average of a health
plan based eighty percent of your
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medical expenses and you pay twenty
percent this plan does not have a
deductible and let's move on to the
platinum plan on average your health
plan pays ninety percent of your medical
expenses and you pay ten percent this
plan does not have a deductible and now
let's take a look at a comparison of
health plans for year 2018 here at the
Medicare berries and coverage for a year
2018 there are a few things to remember
benefits shown in blue are not subject
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to any deductible white corner is
subject to a deductible after the first
three visits copay is for any
combination of services and which
includes primary care and specialist
Urgent Care for the first three visits
as well after three visits they will be
at full cost until the medical
deductible is met let's take a closer
look
as I said for bronze plans you don't pay
the deductible for the first three
visits the lamp is $40 copay and is not
subject to deductible the annual
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wellness exam which is preventive is
included
extra cost the copay for the primary
care visit an Urgent Care is $75 and
specialists visit is 105 dollars this
might be a good plan for those that are
healthy and rarely go to the doctor
obviously if you need more care you will
have to pay more out-of-pocket money the
maximum out-of-pocket you pay is seven
thousand for one individual or fourteen
thousand for the family okay so let's
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look at the silver plan the silver plan
has a lower deductible there are no
restrictions on how many times you can
visit the doctor and again the area that
is highlighted in light blue is not
subject to deductible you will pay
deductible mostly when you are
hospitalized I will add the detailed
summary of benefits under the video for
the full description once is available
the gold plan has no deductible the
co-pays and coinsurance are lower than
those for the silver plan this plan
costs more each month but the insurance
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pays on average 80% of your medical cost
and you pay the rest which is 20%
the platinum plan has no deductible the
co-pays and coinsurance are lower than
those for the gold plan this plan costs
more each month but the insurance pays
on average 90% of your medical cost and
you pay the rest
obviously the platinum plan has the
highest premium each month if you are
healthy and readily go to the doctor it
might not be a good idea to buy the most
expensive plan on the market right now
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as I said in the beginning of the video
I'll share some secrets with you about
selecting a health plan that will fit
your needs and save you money at the
same time so how do you decide which
plan is right for you start by thinking
about your past and future medical bills
for example let's say you're healthy
most of the time and don't expect to
meet costly medical services during the
year then a bronze plan that has the
lower price tag and pays for a lower
portion of your eligible medical bills
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may be a good choice for you on the
other hand let's say you know you have a
medical condition that will need care or
you have an active family with children
who play sports then a gold or platinum
plan that pays for more your medical
costs may be a better fit for you
also it is very important to look at the
summary of benefits for any plan you are
seriously considering this document
tells you what medical services the plan
pays for and perhaps most important
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those it does not pay for make sure you
like the plan type for example a health
maintenance organization or an HMO will
require you to have a primary care
doctor and get referrals for any
specialist you want to see a preferred
provider organization or a PPO will give
you more leeway in choosing doctors also
check the plans provider network
directory to make sure your primary care
doctor is listed if you want to keep
that doctor you can also call your
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doctor's office and ask whether they
accept the specific plan you are
considering check the plans drug
formulary which is the list of covered
drugs to make sure any prescription
medications you take are included thanks
for watching
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