G1 (BAII Plus) HEALTH INSURANCE Insurance against the risk of incurring medical expenses among individuals. Insurancemedical expenses What can health insurance cover? 1. Doctor Visits 2. Hospitalizations 3. Prescriptions 4. Maternity and Infant Care 5. Mental Health © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) What is the Marketplace? Also known as the Health Insurance Exchange — is the place where people without health care insurance can find information about health insurance options and also purchase health care insurance. Will qualify as minimum essential coverage (meaning you won't have to pay the fee for not having insurance). © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) What is Obamacare? ObamaCare (the Affordable Care Act) is a US healthcare reform law that expands and improves access to care and curbs spending through regulations and taxes. © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) What happens if I don’t have Health Insurance? The annual fee for not having insurance in 2016 is $625 per adult and $ per child (up to $2,085 for a family), or it's 2.5% of your household income above the tax return filing threshold for your filing status – whichever is greater. Basically, money will be taken out of your tax return when you file your taxes. © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) If I’m unemployed, do I have to pay a fee? It depends on your household income. If insurance is unaffordable to you based on your income, you may qualify for an exemption from the fee.unaffordable to you based on your income © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) What happens if I don’t pay the fee? The IRS will hold back the amount of the fee from any future tax refunds. There are no liens, levies, or criminal penalties for failing to pay the fee. © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) What’s Included in health Insurance Plans? Co –pay Specific flat fee you pay for a medical service, such as $30 for an office visit. © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) What’s included in health insurance plans? Coinsurance - The amount that you are obligated to pay for covered medical services after you've satisfied any co-payment or deductible required by your insurance plan Example: If your health insurance plan requires a 20% coinsurance for a claim, then the insurance company pays 80% of the claim, and you pay the remaining 20%. © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) What’s included in Health Insurance Plans? Deductible - A specific dollar amount that your insurance company may require you to pay out-of- pocket before your insurance plan makes any payments for claims © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) What’s Included in Health Insurance Plans? Policy Maximum - The maximum dollar amount the insurance company will pay for each person on the policy for covered services during the life of the short-term policy. © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) What’s Included in Health Insurance Plans? Out – of – Pocket Limit – A maximum limitation on all costs for which a patient is responsible under a short-term health insurance plan. © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) What’s Included in health Insurance Plans? Out – of – Country Coverage For an unforeseen injury or illness that begins while the insured person is travelling outside his or her home country or country of residence © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) What’s Included in Health Insurance Plans? Hospitalization - Typically, hospitalization services include services related to staying at a hospital for either scheduled procedures, accidents or medical emergencies. Hospitalization services typically do not include hospital stays for giving birth to a child. © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) What’s Included in Health Insurance Plans? Mental health Coverage - Many health insurance carriers offer plans that cover treatment for mental health concerns such as depression, substance abuse and schizophrenia. What conditions are covered, and to what degree benefits are provided, vary between carriers and plans. Coverage may include medication, treatment at a hospital or medical facility, and out-patient support. © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) Outpatient vs Inpatient An inpatient program requires the patient to live at a facility 24 hours a day. Outpatient programs generally entail treatment within a facility during the day and the patient returns home at night. © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) PPO VS HMO PPO - "Preferred Provider Organization." Like the name implies, with a PPO plan you'll need to get your medical care from doctors or hospitals on the insurance company's list of preferred providers if you want your claims paid at the highest level. © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) PPO VS HMO A PPO may be right for you if: Your favorite doctor already participates in the PPO (use our Doctor Finder tool to find out) You want some freedom to direct your own health care but don't mind working within a list of preferred providers © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) PPO VS HMO HMO - "Health Maintenance Organization." HMO plans offer a wide range of healthcare services through a network of providers who agree to supply services to members. With an HMO you'll likely have coverage for a broader range of preventive healthcare services than you would through another type of plan. © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona

G1 (BAII Plus) PPO VS HMO An HMO plan may be right for you if: You're shopping for a plan with lower premiums You want a plan without a deductible and don't mind having an out-of-pocket limit You need preventive care services such as coverage for checkups and immunizations © Family Economics & Financial Education – June 2006 – Transportation Unit – Shopping for an Automobile Loan (BAII Plus) Funded by a grant from Take Charge America, Inc. to the Norton School of Family and Consumer Sciences at the University of Arizona