I’m trying to sign up for health insurance. And I don’t understand at all what are monthly premiums, out-of-pocket costs, deductibles, and any other lingo. Can anyone PLEASE explain this to me like you would to a 5 y/o?
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I work in dental, so the insurance part is a little different.. but this is a good tip.
Your insurance says they will pay 80% for a specific procedure. Ex. A filling. However the insurance will pay 80% of their “allowed amount” and the unpaid balance is the patients responsibility.
Some dental offices will charge $100 and others will charge $500 for the same filling, same technique. But your insurance may have a maximum allowed amount for this specific procedure at $80. Meaning they will only cover up to $80 for this procedure.
So if you go to $100 filling office, after deductible, your patient portion for the filling is $20.
But if you go to $500 filling office, after deductible, your patient portion would be $420.
My advice is to always preauthorize your treatment. This means your provider will submit a request to get these services covered and that way you know beforehand what they will cover exactly.
Go to an in network provider ALWAYS
And get second opinions.
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