HAVE NOW. THE DOCTOR SAT DOWN WITH A
COUPLE OF COMEDIANS TO HELP THEM
OUT.
OUT. >> QUIRKY.
>> QUIRKY. REALLY GOOD.
REALLY GOOD. >> TO HELP YOU BUY HEALTH
INSURANCE, I’VE BEEN LISTENING
TO THESE TWO SELF-MADE EXTREMELY
TALENTED INDIVIDUALS.
TALENTED INDIVIDUALS. >> OH, OKAY!
>> I’M A COMEDIAN.
>> I’M KATHERINE.
I’M ALSO A COMEDIAN.
WE DO A PODCAST TOGETHER.
IT IS A PODCAST ABOUT SEX, LOVE,
DATING, TEXTING.
DATING, TEXTING. >> YOU TALK ABOUT THE
TERMINOLOGY OF HEALTH INSURANCE.
>> WHAT’S INTERESTING, I HAVE
THIS BUT IN NO WAY DO I
UNDERSTAND IT.
UNDERSTAND IT. >> WE’LL GO THROUGH THE BASIC
WORDS THAT DEFINE EVERY SINGLE
HEALTH PLAN.
HEALTH PLAN. I’LL SHOW YOU A WORD.
YOU RING A BELL WHEN YOU CAN
TELL ME WHAT THE WORD MEANS OR
WHAT IT STANDS FOR IF IT’S AN
ACRONYM.
ACRONYM. >> I -- A DEDUCTIBLE.
STUFF THAT YOU PAY.
>> A DEDUCT I BELIEVE IS A
NUMBER IN YOUR HEALTH PLAN THAT
YOU HAVE TO REACH ANNUALLY,
MEDICAL EXPENSES, BEFORE YOUR
INSURANCE STARTS TO REALLY COVER
YOUR EXPENSES.
YOUR EXPENSES. >> WAIT A MINUTE.
THAT EXPLAINS WHY --
>> SO YOURS IS $4,000.
THAT MEANS IN ONE YEAR, YOU HAVE
TO PAY YOUR MEDICAL EXPENSES, UP
TO $4,000.
TO $4,000. AND THEN AFTER THAT, YOU’RE JUST
PAYING A CO-PAYMENT OR A MUCH
SMALLER PERCENTAGE.
SMALLER PERCENTAGE. >> YOU’RE PAYING $4,000.
>> WHY BOTHER PAYING INSURANCE?
>> IT DOESN’T REALLY COME TO
$4,000.
$4,000. MY DEDUCTIBLE IS $20.
>> BUT GOD FORBID YOU GET HIT BY
SOMEONE DRIVING THE WRONG WAY
GOING BACKWARDS AND YOUR MEDICAL
BILL IS $25,000.
THAT INSURANCE WILL HAVE YOUR
BACK.
BACK. BECAUSE YOUR DEDUCTIBLE WILL
KICK IN WAY BEFORE THAT.
IF YOU GET HIT BY A BUS, I HAVE
WAY BIGGER PROBLEMS THAN
DEDUCTIBLE.
DEDUCTIBLE. >> SO CO-PAY IS LIKE YOUR BIG
FEE THAT YOU’RE GOING TO PAY ANY
TIME YOU GET A MEDICAL SERVICE.
$25 TO SEE YOUR DOCTOR THAT’S
UPTOWN.
UPTOWN. $250 EVERY TIME YOU GO TO THE
E.R.
E.R. >> YOU DON’T GO THERE FOR A COLD
OR A SPRAINED ANKLE.
YOU GO TO YOUR NORMAL DOCTOR OR
URGE END CARE.
>> AND I HAVE URGENT CARE.
>> LET ME ASK YOU THIS.
WHY DID THEY TACK ON THE CODE?
>> WHEN YOU SIGN UP FOR HEALTH
INSURANCE, YOU AND YOUR
INSURANCE COMPANY ARE IN IT
TOGETHER.
TOGETHER. WE COVERED DEDUCTIBLES.
>> NOW THIS TO ME --
>> IN MY MIND, I’M ON A BREAK.
MONEY YOU DON’T HAVE.
AND THEY’RE LIKE, TAKE IT TO THE
MAT.
MAT. >> I’M SO PROUD OF YOU.
THAT WAS AMAZING.
>> IT COULD BE RIGHT.
THERE IS NO SUCH THING AS RIGHT
OR WRONG.
OR WRONG. >> OUT OF POCKET MAXIMUM IS THE
MAXIMUM AMOUNT YOU WILL PAY IN A
YEAR.
YEAR. WHEN YOU HIT THAT, YOUR
INSURANCE WILL PAY FOR
EVERYTHING.
EVERYTHING. ALL RIGHT?
ALL RIGHT? >> GOOD FOR THE YEAR.
WE’LL GIVE YOU A SCENARIO.
RIGHT?
RIGHT? GOD FOR BID WHEN YOU GET
HOSPITALIZED AND YOU HAVE A BILL
OF $20,000.
OF $20,000. >> I REALLY DON’T LIKE THAT.
SO MUCH MONEY.
>> YOUR DEDUCTIBLE IS $5,000.
AND YOUR OUT OF POXFOF POCKET MA
IS $7200.
IS $7200. AFTER YOU HIT $5,000, FOR EVERY
OTHER BILL FROM NOW ON, I’M
GOING TO COVER A LARGE
PERCENTAGE OF THIS.
WHEN YOU HIT $7200, YOU’RE GOOD.
WE WILL COVER YOU FOR THE REST
YEAR.
YEAR. THIS IS WHY IF SOMEONE IS
HOSPITALIZED FOR SIX MONTHS AND
THE BILL IS A MILLION DOLLARS,
THEY’RE NOT PAYING A MILLION
DOLLARS.
DOLLARS. YOU’RE PAYING 20% AFTER YOUR
DEDUCTIBLE UNTIL YOU HIT YOUR
MAXIMUM.
MAXIMUM. >> LAST BUT NOT LEAST.
CATASTROPHIC A HEALTH INSURANCE
PLAN.
PLAN. YOU DON’T PAY A LOT OF MONEY.
HERE’S THE KICKER.
GETTING THE CATASTROPHIC PLAN,
YOU HAVE TO QUALIFY.
PROBABLY GOOD FOR THAT.
>> OKAY.
>> OKAY. YOU HAVE YOUR HEALTH INSURANCE
PLAN PULLED UP IN FRONT OF YOU.
WHAT ARE YOUR DEDUCTIBLES?
>> MINE IS $4,000.
>> THIS LOOKS LIKE $250 A
PERSON.
PERSON. $500 A FAMILY.
>> WHAT IS YOUR OUT OF POCKET
MAXIMUM?
MAXIMUM? >> $7600.
>> $7600. >> MINE IS $1,000.
>> YOURS IS SO MUCH LOWER.
>> HOW MUCH DO YOU PAY A MONTH?
>> $435.10.
>> $435.10. SO SO MINE IS ONLY $100 A MONTH.
>> THAT’S THE DIFFERENCE BETWEEN
GETTING INSURANCE FROM AN
EMPLOYER VERSUS AN INDIVIDUAL.
>> IS THERE ANYTHING THAT YOU’RE
NOW SEEING THAT YOU’RE SAYING,
OH, I DIDN’T KNOW THAT WAS IN
THE PLAN.
THE PLAN. >> IT ONLY SAYS PEDIATRIC DENTAL
CARE.
CARE. WHAT IF YOU’RE IN YOUR 30s?