33 Ways
Not to Screw Up
Health Insurance
Table of content
Introduction
1. Health care in the united states is different from health insurance
How Insurance Costs are Calculated
2. My healthcare journey can help you understand your journey
3. Understanding how health insurance companies design health plans
4. Ten essential health benefits every plan should include
5. Taking control of your health insurance plan – how to read a summary of benefits and coverage plan outline (SBC)
Video Explanation of Copays Deductibles
Coinsurance and an Example
Glossary: Know the Difference Between
Networks: PPO, POS, HMO, EPO, None PPO Example
6. How to read an explanation of benefits - Bonus chapter
Opening the Hood on How Provider Groups Work
7. How do I find a doctor or specialist?
8. What is a prescription drug card?
9. Understand the difference between a health plan offered by my employer and an individual health insurance plan?
10. Beware of indemnity plans and non-major medical plans
Short-Term Medical Plans
Medical Cost-Sharing Plans
Minimum Essential Coverage (MEC)
Minimum Value Plan (MVP)
11. Know the upside to high-deductible health plans?
12. Understand where Medicare fits in
13. Know what the marketplace means
When Can I Apply for Coverage?
Who is Eligible to Use the Marketplace
When Should I Use the Marketplace
14. Premiums and subsidies (advance premium tax credits) make a big difference in cost Subsidies
Bronze Silver Gold Platinum
Catastrophic/Secure Plans
What Are Plans Required to Cover?
Special Enrollment Periods
15. How do i choose the best health insurance plan for me?
Step One – Assess your health and plans available
Step Two – Calculate expenses for a typical year
Step Three – Calculate the worst-case year
16. What should you consider when transitioning from an employer’s health plan to individual health insurance plan
Things To Consider
17. Under 26 years old? Should I stay on my parent’s health plan?
18. What if I forgo benefits?
Medicaid
19. Realize there is a difference between cobra and state continuation
20. Understand the difference between an FSA, HRA, AND HSA
Flexible Spending Accounts (FSA)
Health Reimbursement Arrangements (HRA)
Health Savings Accounts (HSA)
HSA Guidelines
21. When does your medical insurance cover eyes and teeth versus standalone vision and dental plans
22. Beware the difference in coverage between commercial insurance (employer and individual) and Medicare (for those who qualify for Medicare)
23. More than 50% of people insured faced questions and problems with health insurance
24. How provider network problems happen
25. Claims payment problems happen
26. How do I afford my medications?
27. How do I save on medications
28. What do i do if i have a major claim and can’t afford to pay my deductible and coinsurance
29. How to take control of your doctor’s visit
30. Why we have pre-authorization problems and what to do about it
31. Keeping track of your treatments
32. Working with a health insurance agent
33. Understand the future of healthcare
Biologic Drugs
Pharmacogenetics
AI In Healthcare
Summary
Before You Go
Additional References
Acknowledgments