Some things in life are simple. Understanding your health benefits isn’t always one of them.
We’re here to help make it easier by explaining how many health plans work.
ON SCREEN TEXT: Things to Know
Your health plan provides coverage to help you pay for medical care and prescriptions.
ON SCREEN TEXT: Premium
A “premium” is the amount you pay out of your paycheck for coverage. In return, your health plan provides coverage when you need care and helps you stay healthy.
ON SCREEN TEXT: Network
The amount that’s covered depends on whether your doctor is in your health plan’s “network.” Network doctors have agreed to charge a certain amount for their services, so you will likely pay less when you use them.
ON SCREEN TEXT: Copay, deductible, coinsurance, out-of-pocket limit
Health plan terms can get a little confusing. But there are a few more you need to know:
ON SCREEN TEXT: Copay
You might have a “copay” – the set amount you’ll pay each time you visit the doctor.
ON SCREEN TEXT: Deductible
There’s the “deductible” — the amount you spend each year before your health plan starts to pay.
ON SCREEN TEXT: Coinsurance
There’s “coinsurance” — the percentage you pay for services once you reach your deductible.
ON SCREEN TEXT: Out-of-pocket limit
And there’s the “out-of-pocket limit” — the most you’ll pay for network services during the year.
ON SCREEN TEXT: Pharmacy
There are also a few important words you should know when visiting the pharmacy.
ON SCREEN TEXT: Generic Drugs
Generic drugs are just as safe and effective as their brand-name counterparts, but usually cost a lot less.
ON SCREEN TEXT: Non-preferred Brand-name drugs
Non-preferred brand-name drugs will cost you the most and there’s almost always a more affordable option.
ON SCREEN TEXT: Preferred brand-name drugs
And finally, preferred brand-name drugs. They cost more than generics but less than non-preferred brand-name drugs.
So, keep these in mind to help you get the most out of your pharmacy benefits.
ON SCREEN TEXT: Choosing Coverage
There are two common types of health plans:
ON SCREEN TEXT: Traditional Health Plans, premium + deductible (the word premium is stretched to appear larger, and the word deductible is shrunk to look smaller)
Traditional health plans typically come with a higher premium and lower deductible.
ON SCREEN TEXT: High-Deductible Health Plans, premium + deductible (the word premium is shrunk to appear smaller, and the word deductible is stretched to appear larger)
And high-deductible health plans may have a lower premium and a higher deductible.
Some high-deductible health plans also come with a special account.
ON SCREEN TEXT: Health Reimbursement Account
ON SCREEN TEXT: HRA
ON SCREEN TEXT:
- Owned and funded by your employer
- Helps pay eligible medical expenses
A health reimbursement account or HRA – is funded by your employer and is used to help you pay for eligible medical expenses - like a doctor’s visit or x-ray.
ON SCREEN TEXT: Health Savings Account
ON SCREEN TEXT: HSA
ON SCREEN TEXT:
- Tax-free contributions
- Save and pay for health care expenses
- Now and in the future
A health savings account, or HSA is a bank account that lets you put money aside, tax-free, to save and pay for health care expenses now or in the future.
Be sure to check with your employer to see if your health plan also offers other benefits like vision and dental coverage or wellness programs.
ON SCREEN TEXT: Getting Care
ON SCREEN TEXT: Routine preventive care 100% covered in-network
To help keep you healthy, health plans offer 100 percent coverage for routine preventive care like a mammogram or annual wellness exam.
And if you get sick or injured, you have options.
ON SCREEN TEXT: Primary Care Physician
You can visit your primary care physician – who knows you and your health history best.
ON SCREEN TEXT: Virtual Visit
See a doctor anywhere, anytime with a Virtual Visit on your mobile device or computer.
ON SCREEN TEXT: Convenience Care Clinic
Stop by a convenience care clinic located in many retail stores.
ON SCREEN TEXT: Urgent Care Center
Visit a nearby urgent care center. They’re often open late and on weekends with no appointment necessary.
ON SCREEN TEXT: Emergency Room
And remember, if it’s a true emergency, go to the nearest hospital emergency room or call 911.
All of these options provide quality care but costs will vary, so be sure to consider which option provides the care you need at the best price.
ON SCREEN TEXT: That's it!
We hope this video has helped you understand how health plans work, so you’ll now feel more confident using your own plan.
UnitedHealthcare
