What Should Major Highlights of Healthcare Policy Be?

Updated: Oct 24, 2021





Video Transcript:

Sup, everybody, Ben green here with Ben green financial. And of course, we're here to optimize your career, your location and your finances. And today it, we're in October, and this is, this is open enrollment month starting now, November in December, of course. So one to highlight some things that you need to be thinking about when you are selecting your health insurance plan, either if it's through your company, or if you're getting it on the marketplace by yourself. Alright, so here we go. So first thing you need to think about, of course, is the premium that you're going to be paying, of course, the premium, or the price you're going to be paying is really important, because you can have a fantastic plan, but if it costs you, you know, like $5,000 a month or something that that of course is not going to make sense. So you need to make sure that the premium is a is affordable for you. And also that you can once you pay the premium, you can actually pay the the CO pays, which is the next thing that's really important. So co pays are things like know the amount you're going to pay if you have to go to see your primary doctor or a specialist, or if you have to go to the ER room, for example, typically is like you know, 10 2030 bucks, maybe as much as $50, to go see your primary doctor, maybe 60 or $70 to go see a specialist. Depending on the plan you have, it may be $200 to go to the ER room, some plans or $1,000 copay to go to the emergency room. And so you need to just make sure that you're in a plan that has has reasonable co pays, and hopefully a reasonable premium. Next thing you need to think about, of course, is co insurance. And so for things like surgeries, or if you are, if you're staying in the hospital for overnight, as an example, the bill may be $1,000 and your coinsurance portion may be 50%. For example, you may have to pay half of that $1,000 as coinsurance, you have to check coinsurance when you are checking your health insurance plans and deciding on what you're going to get into. Last thing that really hits a lot of folks is the maximum out of pocket or moop, m o p The moop is called the maximum out of pocket. And with a good quote unquote health insurance plan, the moves are typically around 3000 or $4,000 in a year. So even if you got a bill that was a million dollars, for example, your maximum out of pocket in a year, if your if your move is $5,000. The maximum in a year that you want to pay out of your pocket besides your premium is $5,000. Alright, so you want to have as low of a move as possible. There are plans out there where you can have a $10,000 maximum out of pocket, we've seen plans where it's like $15,000, maximum out of pocket, and that's for an individual, if you're a family, then you need to take your move and basically multiply by at least two. So if it's you and your spouse, for example, and your individual maximum out of pocket is $5,000 probably means your family's out of pocket maximum is going to be $10,000 in a year. And if you don't have that kind of change, you need to figure out some other options like some supplemental type insurance, for example, or baby getting a better, richer plan. Alright, last thing that a lot of folks do forget about is the RX or the prescription co pays, of course want to make sure that those are reasonable, especially if you have to get some specialty type drugs in the kind of the tier three, four or five level. Alright, so to wrap it all up your premium of course is really important co pays are super important. Your coinsurance is important especially if you have some surgeries coming up your maximum out of pocket in a year is really important. And then RX your prescription co pays can be really important. You need to take a look at those things. If you have any other questions, hit me up hit me up on my YouTube. We appreciate all the subscriptions that have come in, hit me up on my website been in green calm and happy, open rope season. Thank you



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