HEALTHCARE INSURANCE – THE BASICS

Lesson Objectives Students will learn the pros and cons of health insurance Students will be introduced to the different terms related to health insurance Students will compare health insurance plans Financial Literacy Healthcare Insurance

Learning Outcomes Students will better understand the complicated system of healthcare insurance by exploring the critical terms within and comparing healthcare plans. Financial Literacy Healthcare Insurance

Why Health Insurance?

What You Should Know About Health Insurance Health Insurance: The Basics What You Should Know About Health Insurance Insurance costs a lot but having none costs more If your employer offers insurance, grab it Comparing plans is tough but necessary The lowest premium isn’t always the cheapest plan Even good coverage can have big loopholes You’ll pay more for freedom You can check out networks before signing up You can keep your insurance if you lose your job Working couples have more to think about Tax breaks can help Top ten provided by Financial Literacy Healthcare Insurance

Why Pay for Health Insurance The Basics Why Pay for Health Insurance At some point in your life you will probably need expensive medical care Health Insurance, like other kinds of insurance, protects you against significant financial loss It ensures you can afford medical help when you need it Health Insurance can help keep you healthy by detecting and treating dangerous medical conditions before they become serious Financial Literacy Healthcare Insurance

Different Types of Insurance

Types of Health Insurance INFO PRO CON Fee-for-services: pay as you needed Visit any provider Expensive/restrictions on what services provided HMO Pay monthly premium Lower Cost Visit only in-network providers PPO Visit in-network providers and some reimbursement for out-of-network providers More expensive than HMO More restrictions than Fee-for-service Medicare Insurance for 65+ and some disabled Paid for through wages already collected by government Limited coverage and providers Medicaid Public Assistance Program – based on financial need Free insurance for those in need Minimal coverage and must qualify under local guidelines UNIT 3LESSON 6 Financial Literacy Healthcare Insurance

Some things to Consider when Comparing Health Insurance Plans Premiums Copayments – Office Visits and Prescriptions Deductible Co-insurance Out-of-Pocket Expenses Emergency Room Financial Literacy Healthcare Insurance

Premiums The amount you pay monthly for your selected health insurance. Option 1 Employee Employee + Spouse or child Employee + Family Premium $500 $825 $1,010 Option 2 Employee Employee + Spouse or child Employee + Family Premium $300 $600 $775 Option 3 Employee Employee + Spouse or child Employee + Family Premium $150 $350 $500

Premiums Complete the Comparing Health Care Premiums activity. Financial Literacy Healthcare Insurance

Co-pays The cost you pay at the time services are rendered. Typical copays are for office visits, prescriptions, and emergency room visits. Co-pays Option 1 Option 3 Office Visits $30 $20 $15 Prescriptions Emergency Room $100 $200 Financial Literacy Healthcare Insurance

Deductible The amount you will pay for services BEFORE your health insurance will start paying. You start this process over at the beginning of every year. Typically, the higher the deductible, the lower the premium.  Deductible Option 1 Option 2 Option 3 Deductible per person $1,000 $1,500 $2,000 Deductible per family $3,000 $4,500 $6,000 Financial Literacy Healthcare Insurance

Employee + Spouse or child Co-insurance Once your deductible amount has been met (you have paid for services in the amount of your stated deductible), your insurance kicks in and starts paying for its share of coverage; but only at the rate stated in your plan. Co-insurance (in %) Employee Employee + Spouse or child Employee + Family 90/10 80/20 70/30 Financial Literacy Healthcare Insurance

Out-of-Pocket Expenses This is an agreed upon maximum amount that you will pay for services out-of-pocket. This amount starts being calculated at the beginning of each year. Typically any amount you pay towards your deductible and co-insurance is put towards this balance. Out-of-Pocket Expenses Employee Employee + Spouse or child Employee + Family 90/10 80/20 70/30 Financial Literacy Healthcare Insurance

Complete the lesson

Complete the Lesson… Complete the Comparing Health Plan Options activity. Financial Literacy Healthcare Insurance