33 Ways
Not to Screw Up
Health Insurance

Introduction 

1. Health care in the united states is different from health insurance
How Insurance Costs are Calculated

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2. My healthcare journey can help you understand your journey

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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

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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)

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11. Know the upside to high-deductible health plans?

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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

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17. Under 26 years old? Should I stay on my parent’s health plan?

18. What if I forgo benefits?

Medicaid

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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

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21. When does your medical insurance cover eyes and teeth versus standalone vision and dental plans

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22. Beware the difference in coverage between commercial insurance (employer and individual) and Medicare (for those who qualify for Medicare)

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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

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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