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Fake hospital bill receipt for Insurance Industry

all right we are back with an important and timely consumer confidential our health insurance plans reset at the beginning of the year so now is a good time to review your benefits for me it's like eating vegetables you just you gotta do it right I'm here to explain what some common but confusing terms mean and tell us about important Medicare changes we have senior consumer investigative correspondent Vicki Nguyen good morning to you good morning I'm like okay I know we all want to glaze over but we're going to do the 101. let's do it all right so first we're going to start with the fact that it's hard to understand like the coverage like yeah how to break it down so at its most basic right health insurance is basically a plan that protects you from having to pay for the full cost of your health care which at any given time we don't know what may or may not happen so that's basically what it is you know it's a hard decision where you if you choose to pay more every month like it's just such I know because it may make Financial sense but it's just like why do I want to why do you want to do that well typically people get it through either their employer or through the government the Affordable Care Act or Medicare okay and so the first term that you want to pay attention to is your premium that plan how much do you want to pay for what kind of coverage you pay more now so that you can pay later less it's going to be up to you the next term to think about is the co-pay so that's the fixed cost you pay for every doctor's visit if you have to go to the ER your copay does not apply to your deductible people sometimes wonder about that the hard way yes your deductible often insurance companies require you to pay a certain amount a thousand dollars twenty five hundred depending on individual or family coverage before they kick in and start shipping in money towards towards your health care and that can hurt if it's high because you know you feel like I've been going on I've been paying and paying and pain and my insurance isn't kicking in exactly and then finally the out-of-pocket maximum is exactly what it sounds like that is the most you will pay once you've hit that dollar amount after paying your deductible the insurance company pays for 100 of your care but remember that resets every year so one-on-one set yes okay so for the folks 65 and older yeah government announcing changes for Medicare Medicare Advantage yeah those changes a lot of positive changes also the government passed the inflation reduction act last year it takes effect this year it means the government has more power to negotiate for our prescription drug prices so we're going to see costs come down on things like blood thinners cancer medications and the all-important insulin so that is right is that for everybody or just medicine that's folks on Medicare the deductible for Medicare Part B also comes down it's the first drop in a decade it's only seven dollars but the deductible is now 226 dollars this I really want folks to pay attention to so the recommended vaccines including shingles which can cost up to two hundred dollars for the two dose course that's now free same with your covid-19 backs your flu vaccine your pneumonia vaccine so take advantage of the free vaccines and finally insulin co-pays capped at 35 a month but not for all insulin so ask your doctor about that okay so you sign up for everything we've just you know put our hands in the air fine this is what I have how do you make the most of what you signed up for you got to do the thing where you set aside an hour or two to really walk through your plan and know what your cover averages you know who the in-network providers are versus the out of network providers the good thing about covid is it made a lot of our Telehealth visits free that is now covered by insurance so take advantage of those and the next thing is know the difference between an FSA and an HSA like the flexible spending account versus the health savings account that's all tax free money the HSA is your own you can take it doesn't matter where you work the FSA is attached to your employer you have to use it or you lose it every year but it's great if you know you have health costs coming up you put aside that money it's not taxed it lowers your taxable income finally get around to scheduling the OB GYN the physical just get that done it's included it's included preventative care is generally always covered at 100 with insurance and then lastly we know prescription drug medication pricing is so opaque it's all over the place list out all your medications ask your doctors whether you can take generics and go online Sometimes using your insurance is not the cheapest way okay one of the leading causes of Bank in this country medical bills and they get out of control easily especially after procedure are those bills negotiable at all Vic this is so important they can be and here's what you need to do first you need to know what is your bill exactly line by line the items you've heard those stories about getting charged 15 for one ibuprofen pill highlight everything that is wrong or seems exorbitant then you're gonna go to there's a couple of websites I want to tell you about Fair health and Healthcare Blue Book that'll tell you how much these procedures are supposed to cost in your area oh wow call the hospital right and you say okay here's what it should be what can you do for me be polite be firm be persistent so these two websites tell folks what they should be paying in their area because of course a gallbladder removal somewhere is not the same as it is somewhere else which is frustrating about Healthcare then ask if you are below a certain Financial level you may be able to lower the entire Bill and of course set up a payment plan if that's going to be what makes it easier for you to pay and finally there's a whole industry called medical bill Advocates if you're caring for someone who has a lot of medical bills or maybe you're too sick to deal with all of this yourself sometimes the cost of hiring one of these companies to do the negotiation for you will save you more in the long run really quickly we just want to show folks some of the items just to remind folks that are not covered by Insurance definitely not cosmetic procedures last week we were talking about buccal fat removal from your cheeks that's not going to be covered what I was so surprised fertility treatments often are not and also elective procedures the shoulder replacement the hip replacement sometimes that's considered elective they don't cover it right well it depends if your doctor they work with you exactly you want to make sure you know before you go into it your money's worth out of their insurance thank you so much hey thanks for watching don't miss the Today show every weekday at 11 A.M Eastern 8 Pacific on our streaming Channel today all day to watch head to today.com all day or click the link 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