Health Insurance 101: How Insurance Works In 90 Seconds | BCBSND

[@pyroAdapt]

I went to a clinic cause I have a sprained ankle. I have blue cross blue shield and they told me I still had to pay a 150 dollar co pay for the visit . Keep in mind this is in the waiting room before I've even had anything done yet. I didn't have that much to spend on a copay and ended up just going home and treating it myself and am still recovering and healing pretty well. I messaged my mom to vent about this to her because she's my only relative who works in health care so she's the first person I usually talk to about this this stuff and she told me without insurance It probably would've been like 800 so that's a good deal and I was like no the f**k it isn't! All that tells me is that Insurance is useless because regardless if it's 800 dollars or 200 Dollars I still can't afford to pay it so it doesn't make a difference if it's slightly out of my budget or way out of my budget. If I don't have the money I don't have it plain and simple. Technically I have that in my bank account yes but that's basically all the money I have til my next check since I live pay check to pay heck so I would basically be saying goodbye to food and gas money for the next week and a half all to get my ankle examined. This shit is absolutely absurd.

[@Sora_Nai]

Get a better job, why are you living pay check to pay check. Do you live alone, get a roommate, you live in an expensive area, move? Do you even budget, stop spending on stupid shit? There is no reason to be living pay check to pay check. Do you have a kid that is your own damn fault, if you're broke af why tf would you have a kid? Even when I was making 24k a year I was never living pay check to pay check, I was able to save $400 a month to make a good safety net for myself which I used to learn new skill and get a better job. So unless you were born with some sort of disability, you have no excuse.

[@MeherScholar]

If you have to go to an urgent care clinic, ask what their cash rates would be if you choose not to use insurance. I learned about this strategy in the book "NEVER PAY THE FIRST BILL" by Marshall Allen. I went to an urgent care with a sore throat to see if I might have the flu. When the bill came in the mail, it was $824.55 reduced to $608 because I have insurance. But if I had said up front that I didn't want to use insurance, they would have accepted $324 cash. However had I not gone to an "in network" provider at all and simply walked into the local Walgreen's, I could have gotten the same test for $19, no insurance needed. You can also get blood tests cheaper by going straight to places like Quest and not getting a doctor order. Same with some imaging services. Ultimately you saved the most money when you decided your sprain might heal on its own (I'm glad it wasn't a break.) The moral of the story is to research all your health care options in advance to figure out the most economical avenue. It takes time and effort but it's worth it. Someday you will need health care, so do try to find out the cheapest way to get it.

[@isaiakrozell2409]

Dude, I'm going through the same thing now and it's stressing me out so much.

[@ihuomatuesday1600]

I feel your pain. My sentiments exactly. We are the working poor and it pisses me off to have to choose between food, gas, paying rent, etc. No $ left to enjoy life after working so hard. I haven't had a vacation in years. Im so stressed and tired

[@cutty02]

Yes but what if it was an actual emergency and you didnt have a choice. Then you will be actually screwed without insurance.

[@AislingBast]

Thanks for the new video! I’m looking forward to seeing what other content you post! Always good to learn as much as you can!

[@doreenmarcum5341]

I would like to know why didn't you show the difference of the billed amount and the allowed amount. The fee schedule or contractual obligation for the hospital. If you are going to show the public how it works, I would suggest showing exactly how it looks so they know that the total amount that is billed is not the total amount that is paid to the provider or facility.

[@lauravlad7216]

Correct! It seems like Blue Shield of CA together with the other private companies don't like transparency. There's always some shit they hide under the rug for us to discover later.

[@godismystrengthitsmexaj7007]

Because it is still depends on the procedure code / cpt code use by your provider.

[@MeherScholar]

Excellent point. And since January 2021, hospital based providers and insurance companies have been required by the federal government to disclose allowed amounts to patients who want to comparison price shop between providers. Always ask the provider for a "Good faith estimate" before receiving tests, procedures or services. And call the number on the back of your insurance card and ask where to find the insurance company's online cost estimator tool for comparing rates at different health facilities. The difference in prices between providers can be staggering. Don't just automatically go to the big-name-brand health care provider in your town. They probably charge the most! Final tip: before scheduling any service, call various providers' billing customer service and see how easy it is to reach anyone who is friendly. See if they are willing to help you understand in advance what the charges might be. That can be a big clue right there.

[@itsdasiavu]

agreed

[@vincentkingsdale8334]

Don't forget the premiums

[@elianasmith6330]

Your videos are very useful and provide lots of information. I have received lots of help after watching this post, please continue to share this kind of information. Thank you.

[@CC-kl4nh]

When you realize your healthcare is in the hands of corporations, you as an individual is screwed. It needs to change.

[@jkbc]

I like this explanation, all insurance company should provide this example of calculation. At the end of the day, people has the right to know what they will pay. but all Insurance companies tried so hard to hide them. People pay so much for their monthly insurance thinking that they are covered if something bad happened. That was not always the case, after the expensive monthly premium you religiously pay, you will still have to pay MORE when you actually need medical treatment.

[@scorch4397]

Why did they leave out how much you have to pay every month!

[@ES-7766]

Because it’s different for everyone, depending on job matching and/or age.

[@covidisascam4556]

Only in the US you have to do mental gymnastics with your health insurance.

[@CamilaElla-c1b]

Awesome content. Quite interesting and very useful. Thank you for sharing this wealth of information. Thanks.

[@realtalk2046]

These people in the comments are upset, maybe I am somewhat ignorant due to my relative good health-I did have an ACL surgery about a year ago and PT stopped short… but this video does a great job explaining.

[@AlexaAlba-l4g]

I like your video presentation. It is informative too, at the same time. Thanks a lot for your guidance!

[@AnthonyMartinez-rx1if]

So I would pay $608 the first time , and let’s say i go back same year same bill , I would only pay $108 the second time ?

[@teeceedoc]

Yes

[@maxxquinteros4974]

Got it!!

[@sandiego764]

Actually you'd pay $208 -> $10 Copay +20% Coinsurance of 990 = $208

[@MichaelSkinner-e9j]

Whenever a hospital orders, their accounting has to be in line with federal guidelines, what the insurance are billed, patient billing, and so forth. Otherwise, they have to worry about fraud (ordering too much, which IT HAS TO GO SOMEWHERE)

[@teeceedoc]

I didn’t understand insurance but now understand it, it seems like Life and Auto are the only important ones and that you should save a lot of money and be careful

[@jeffsouth5416]

when you include your monthly premium to what you still have to pay, insurance pays very little if any

[@boomerskin4457]

Only in America will you need to explain how healthcare works to people

[@shabbirnasir]

shabbirhealth.blogspot.com/2022/08/how-to-adopt-conscious-and-sustainable.html

[@joshuatate5671]

Who hurt you bruh

[@liljkt]

😂

[@edelynilagan5627]

hahahah

[@CitybytheB3ach]

Facts I wish school thought us this shit

[@wormoSTEEZE]

having the math example helps so much. thanks!

[@MikeyLee559]

I'm confused, but don't you already pay the 200$ or so a month for the insurance it self. So why would u still owe the 500$ deductible?

[@personalstory5178]

​@MikeyLee559 What they don't show is what I call the "No" Deductable. Hospitals would charge a lot more, and insurance would dispute (or negotiate) the bill, lowering it substantially. That's where this math comes into play. By paying the $200 or so a month ($2400 a year), you wouldn't be screw paying tens of thousands for an emergency. What gets approved by insurance is stupid, and what hospital charges are stupid, too. My anesthesia (not the surgery) for my tonsillectomy cost about $8,000! Insurance did the "No," and the price dropped to about the hundreds, I only paid for $90 at the end. The anxiety I felt knowing that if I don't have insurance, I'll be up a creek if something does happen to me would is worth the $2400. Do I sound like a fool that got trick? Yes! Because the health care system is stupid!

[@cdgates1]

What is the difference between PPO 3 vs PPO 1?

[@silvermadero1186]

What covers a septoplasty I need my nose corrected not able to breathe well through my nose

[@jessicanunez8469]

Well explained and well broken down to the T.

[@radhikapatel1221]

I didn’t understand.. please start from what happens is I pay $1000 a month in insurance. Have pregnancy visit.. how does it work?? This is confusing.

[@la3928]

Reach out to your insurance company. They will explain it again for you since they can see your exact policy. Also, when you go to the doctor's office, you can always for the superbill so you can share with the insurance company the codes they used for your treatment and discuss it in detail. Each office has a contracted rate of service.

[@rigovazquez6721]

The best

[@aliciasupergirl973]

What about max out of pocket

[@tylerellefson2417]

In her example she uses a $500 deductible, today 9 years later I have a $5000 deductible!

[@telsamorgan5369]

Thank you a lot for this video. This is very interesting and informative. Keep posting like those amazing videos, this is awesome.

[@sawturkey]

I still don't understand... why did she assume this person met their deductible? How do you meet a deductible?

[@Anu20810]

Insurance is all messed up.

[@wallacerangel616]

You’re not wrong

[@Robert-lo6uf]

10.00 copay? What county is this hospital at? When I was in Mexico I paid 50 pesos to see a doctor and he wrote me a script for medicine. That's a total of $3.50 US dollars. That same service here would have ran me around $200 to see my PCP. It's only a win-win situation for hospitals. Insurance companies and customers are always on the losing side.

[@arika_sun]

Thank you

[@codenamedav]

just be sure to multiply these values by a power of 10 for a more realistic plan

[@bob75819]

so you're stuck paying sixty percent after the 1200 a month premium, don't we just love insurance?

[@Loafer.x]

What if my deductible and copay is 0$ and coinsurance is 20%

[@AshminaMichelle]

Then you're responsible for 80% of the allowed amount

[@oscarmosh]

Insurance in America is a fucking joke.

[@thelostcosmonaut5555]

Heres how health insurace works: 1. You lose a substantial amount of your paycheck to pay for BCBS 2. You have a medical emergency 3. The bill gets sent to BCBS 4. You wonder why your bill is ao high despite having insurance 5. You call BCBS to sort the matter out. 6. BCBS basically says, "Get f*cked, loser." 7. Enjoy debt slavery.

[@lar1664]

Insurance is a scam in this country. You better just take care of your health because the medical industry is built on dependency and death panels, all subsidized and weaponized by the federal government.

[@maddiel3027]

The American dream

[@bear________]

Blue cross blue shield won't pay for name brand prescription your doctor prescribes. But, the substitutes they will pay for with all the side effects go in the trash.

[@vincentkingsdale8334]

She didnt factor in how much the premium was per month

[@CaseyLouis]

Sounds like Blue Shield insurance.

[@blakesharette26]

And you also are paying a premium every month? So even though you only paid $600 out of the $1,000 owed, you probably paid $80 for six months before you went in to the doctor's ($480). So either way, you pay the same amount or more 😂 I guess it depends on how often you have to go to the doctor's.

[@DumbShenanigans666]

Delay Deny Depose it is the foundation of the United States healthcare insurance companys and the mirror scares you. Change your ways. Your actions have consequences

[@codenamedav]

works in presidential politics too.

[@Medicents]

Please don't limit your learning to this video alone. Health insurance is far too complicated to cover in 2 minutes, and this video neglects key topics, like network status, covered vs excluded services, common reasons for claim denials, and how to read a summary of benefits and coverage. Keep learning with other resources (and perhaps not from the insurance companies themselves 👀)

[@chaosordeal294]

My local clinic billed me six times for one procedure. I called BCBSND fraud services. They never got back to me. I will not bother next time. Never excuse as incompetence what is obviously graft.

[@codenamedav]

100%

[@abrahamvaladez6122]

Sure wish we learned in hgih school 😒😮‍💨

[@wallacerangel616]

Same

[@brandonjones557]

500 deductible is so ridiculous. Use realistic numbers. I know this was 9 years ago, but even then those numbers were so far below the real numbers.

[@JacobB-q1f]

What is out of pocket

[@zaq55]

Now explain how Medicare works.

[@suzyq9104]

Covid inpatient will come to oh....6080.00?

[@alexandracasados22]

I’m so confused

[@JojoTheVulture]

Why. Don't. They. teach. This. In school.

[@tellinthetruth]

the greed of money

[@cromaticdragon5079]

Except that's not how it works kzbin.info/www/bejne/l6nNh5x3ZamNma8si=VNVi4mUvlhBLxYlE

[@John-ik9ot]

All good until Obama ruined it...

[@geminigirl1135]

Not helpful at all

[@jebediahconde2143]

So it sounds to me like if you only get hurt once a year we the policy holder pays the lions share of the cost.

[@NoddyNoddyTalk]

Nicjulourr qaunn

[@richard-os9jr]

Don't go to ut health

[@securityofficer9483]

What a rip off

[@بندرعبدالله-ز6ط]

Describe the healthcare system in the United States; Explain the functions of BlueCross and BlueShield; Review how drugs are paid for; Discuss healthcare plans and how they are regulated; Outline the differences between healthcare in the US and Europe; Analyse the key reasons for rising healthcare costs in the US; Describe the functions of Medicare and Medicaid;