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Smart Use Health Insurance AAFCS-06-15
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A Brief Look at Using Your Health Insurance: Now You Have It, How Do You Maximize It?
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Transcript of Smart Use Health Insurance AAFCS-06-15
A Brief Look at Using Your Health Insurance: Now You Have It, How Do You Maximize It?
Presenter
Presentation Notes
Hello! Welcome to Smart Use Health Insurance: Now You Have It, How Do You Maximize It? Regardless of how short or how long you’ve had health insurance, you will leave today with either new ideas about using your health insurance OR with the assurance you are making smart use of your health insurance. What Mia and I will be sharing with you today is a brief look at using your health insurance. Our presentation comes from a larger curriculum we’re launching in 2015—Smart Use Health Insurance. Smart Use is a three part series program designed to help you better access healthcare, understand costs of care, track the services you received, and keep records of health care use and costs. The curriculum is created by a partnership with the University of Maryland Extension and the University of Delaware Extension. It is one of multiple curricula I’ll review at the end of this session.
This session is designed to help you: 1. Understand what key terms and questions you need to know to control health care costs. 2. Know where to go for information about health care billing. 3. Develop strategies to avoid pitfalls.
Presenter
Presentation Notes
This session is designed to help you: Understand key terms and questions you need to ask to control health care costs. Know where to go for information about health care billing Develop strategies to avoid pitfalls. And now, my colleague Mia Russell, University of Maryland Extension Family and Consumer Sciences educator and member of AAFCS will guide you though meeting these three objectives.
Your Questions about Using Your Health Insurance?
Presenter
Presentation Notes
Thank you, Bonnie. Let’s start with questions you have about using health insurance. It will be helpful for you to identify one or more questions as you participate in the session. So take a minute to identify at least one question and write the question on sticky notes provided on the table. Volunteers will collect those questions; Bonnie will review them and we’ll do our best to answer during the session. PAUSE to permit activity. Many of your questions may be addressed during the workshop, however, please note that I may not be able to answer very specific and personal questions. During the workshop you will be receiving information and resources that you can use to access more information. If you have questions after our session, you’ll be able to contact Bonnie or me via email which we’ll post. Thank you for participating. Over the years, I’ve learned that asking the right questions is key to understanding almost anything. In this case, I have a list of key organizing questions we’ll use to frame smart use of health insurance.
My SMART USE
Key Questions I Need to Answer
Why?
• Why do I need to understand health care costs?
• Why do I need to track costs?
What? • What two types of costs will I have? • What documents provide information
about health care costs?
How? • How do I keep track of costs? • How can I avoid financial pitfalls?
Presenter
Presentation Notes
Note to Educator: slide is animated and one section, followed by the pertinent, questions will appear by clicking the mouse. There are three important, key questions to consider when making health insurance decisions. First, you want to consider the “why”- why do I need to understand health care costs and why do I need to track them? Second, you want to consider the “what.” What types of costs are there and what documents provide information about them? We will discuss the types of costs and what documents contain key cost information. Finally, you want to understand the how best to keep track of costs and how to use this information to your benefits Being able to answer these key questions “why, what and how “ will help you make Smart Use of your health insurance.
Why Learn to Use Health Insurance?
Be healthy enough to work
Access preventive services while containing costs.
Prevent and manage chronic illness
Improve health of adults and children
Avoid financial pitfalls
Presenter
Presentation Notes
I don’t know why each of you came today but I assume you want to learn to be smart about using your health insurance. There are several reasons why it is important to be informed health insurance consumers. [If time permits, have audience identify some at their table and/or call reasons out loud. If not, simply reveal these five.] For today, I’ve listed five reasons. One reason is to be healthy enough to work or go to school; another is to able to access services while containing costs. A third reason is to prevent or manage chronic health conditions such as diabetes, etc. A fourth is to improve health of adults and children and finally to avoid financial pitfalls. If a health problem occurs the results can be costly. Health insurance helps reduce that risk, especially the financial one. Being smart about using health insurance helps to prevent financial pitfalls. Note to Educator: Acknowledge the reasons shared by participants as you share these key reasons. Research shows that when people are healthy, they are less likely to miss work or school due to injury or illness. People are usually more productive at their job and get more done. Some businesses are even offering employee wellness programs to help people get health and stay healthy. This can create a Culture of Health where people become engaged, empower employees and the business thrives. Many health insurance plans offer services and programs to help keep you healthy, thus saving you time and money over time. In addition to annual wellness visits, some also offer benefits such as personal wellness coaching, healthy pregnancy programs, gym membership discounts, nutrition counseling, online seminars/webinars, checklists, tools and calculators. Having health insurance can lead to better health outcomes. If you and your family have adequate insurance coverage, based on your health care needs and wants; and use your health insurance as it is intended to be used (prevention visits, immunizations, etc.), this can lead to overall better health for everyone.
Important Words to Know
Presenter
Presentation Notes
To really understand health insurance and to be a good health insurance consumer, it is necessary to understand health insurance terminology. Knowing important health insurance terms helps you to understand how your insurance plan works. So, right now, let’s turn our attention to the puzzle pieces on your table. With others at your table, try to match a word with its corresponding definition. <PAUSE to permit time for activity. Check on time used and time remaining for presentation.> At your table, share the matched pairs reading the word and definition. Thank you for participating in this brief activity. In a longer session, we’d spend more time on terms. Research shows that consumers are confused about health insurance terms. There are several important health insurance words to know. Having the definitions will help you better understand your health insurance plan, other documents and costs. Healthcare.gov is our reference for standard definitions related to health insurance. You have a list of terms in your packet to use after this session. Bonnie’s Notes: Mia, you need to write the script for how to handle this activity and how much time to spend on it. We will use these terms during the remainder of our session.
What Documents Help Me Understand My Health Care Costs?
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Presenter
Presentation Notes
Reviewing the words is useful. Now let’s put it to practice. Insurance cards identify key information about you and your health insurance plan. [Click once to show the card]. Where is your insurance card? Find it and look for information about you. What financial information is provided on an insurance card? PAUSE Although every card will look different, important identifying information such as: Member name, Effective date, Group and member numbers, contact information for the insurance company and possibly your prescription number (if applicable) can be found on the card. This card should be carried with you as proof of insurance but also as proof of the amount of copayment you are responsible for as you use health care services. Be sure to read your card and verify copayments when using health care services. Co-payment or co-pay is one of those key terms to know. [Click to show the co-pay arrow.] To be clear about the definition of Co-pay, it’s the amount you pay for seeing a health care provider like your doctor. Another term, not on this example but one that confuses consumers is the term coinsurance. Co-insurance is the amount you pay for services provided by the doctor. So, if the doctor does a test, removes a growth, etc. , those services must be paid for; they will be sent to the insurance company and to you for payment. Another way is to understand the difference between copayment and coinsurance is to think of the copayment as the ticket price of a concert. The co-insurance is the amount of money spent at the concession stand for food or products purchased at the concert. Now back to your card. Your insurance card is issued by the insurance company after enrollment and lists the amounts of co-payments required when accessing the doctor, specialist, or emergency room. Copayment amounts for doctor, specialist and emergency room and prescription copayment if applicable. This is the amount that would need to be paid at the time of service. Copayments are key out of pocket costs. Let’s look at out-of-pocket costs.
Out-of-Pocket Health Care Costs • Insurance Premiums • Doctors, Dentists and Other Provider Visits • Prescriptions, Insulin and Over-the-Counter
Medications • Hospitalization • Medical Aids, Devices and Equipment • Medical Related Travel • Other Medical Expenses
Presenter
Presentation Notes
To control health care costs we need to start with an understanding of what these costs are. These are the costs that you will typically see and have to pay for. Let’s review this list (ask for examples IF time permits). Once you know what is covered, controlling costs becomes more manageable. Understanding the type of health costs is important so you know what you are looking for to avoid potential financial pitfalls. Costs can be divided into two types: 1) those that you know and 2) those you don’t know. All are out-of-pocket costs –expenses you must pay for, not covered by your health insurance plan. Out-of-pocket costs include premiums, deductibles, coinsurance and copayments for covered services plus all costs for services that are not covered. For more information about these out-of-pocket costs, you can look at your insurance card, Summary of Benefits and Coverage documents you received when you enrolled in the plan, or by calling the insurance provider. Your insurance premium is an example of a “known” type of cost. Premiums are fixed--you know what you will pay each month. Unknown costs are costs that change – or are flexible. These costs are harder to know ahead of time because they only are applied as you use your insurance. Unknown costs can occur before or after the insurance pays; many of these costs are include those shown here. There is an out-of-pocket cost factsheet on our website available free for download. But even understanding and planning for costs, you can still face financial pitfalls. One involves your doctor.
Potential Pitfall: Doctors Drop Out-of-Network
Consumer Problem: You’ll likely pay more to see the doctor. Consumer Action: Check each time you make an appointment and again at the appointment.
Presenter
Presentation Notes
Health Insurance plans have rules for which doctors you can use. Those rules affect how much you pay. Do you know that you’ll likely pay more if your doctor in your health insurance plan’s network. You will. So, let’s be clear about what I mean by “network.” This was one of the words in your puzzle activity. In this case, network is defined as: “The facilities, providers and suppliers your health insurer or plan has contracted with to provide health care services.” Most of us call providers, doctors. Most health insurance plans use networks with doctors who have signed on to work with the insurance company. BUT, not every doctor, hospital and other health care services works with your health insurance plan. Those doctors that participate “in network” cost less than those who don’t. There are some exceptions but for today, the key point is this: Doctors can drop out of networks at any time. How many of you were aware that this can happen during the time period of your plan’s coverage?—Raise your hand if you were aware. Most of us aren’t aware that doctors drop out. A doctor can stop working with a health insurance plan at any time and they don’t always tell you right away when the decision is made. So, what happens if a doctor drops out and you go to them for health care services? [Click for Problem Header and again for problem statement.] You will likely pay more to see the doctor. So, what do you need to do? [Click for Consumer Action Header and again for action statement.] EACH time you make an appointment, then again at the appointment, you need to double-check the doctor or group of doctors in the practice, are still part of your plan’s network. Regardless of the time of year and how long you have had a doctor, you may face staying with the doctor and paying more or seeking a new “in-network” doctor or group of doctors or be willing to pay more for services. To remind you to ask this question, we’ve provided a card with this question for you to keep with your insurance card. Then each time you are asked for your card and if your insurance has stayed the same, you’re ready to ask if the doctor is still in your network of if the situation has changed! Now lets look at a list of essential health benefits; some of which are provided without a co-pay…good to know for your family health budget! PAUSE BEFORE ADVANCING TO NEXT SLIDE> CHECK ON AMOUNT OF TIME REMAINING
What are the 10 Essential Health Benefits?
1. Preventive & wellness visits
2. Lab tests 3. Hospitalization 4. Prescription drugs 5. Services and Devices to
for injuries, disabilities or chronic conditions
6. Maternity and newborn care. 7. Mental and Behavioral Health treatment. 8. Pediatric care 9. Outpatient care 10.Emergency room services
Presenter
Presentation Notes
Did you know that for the first time in our history, we have a health policy focused on prevention of health problems? We do. The Affordable Care Act of 2010 (or ACA). As a result of that public policy, most health insurance plans are required to provide 10 essential benefits to every person covered by health insurance . Knowing these benefits is an important step in controlling your costs. For example, it is important to know that your annual physical or check-up is a covered service and that you aren’t required to pay a copayment for the visit. To help us understand the importance of taking advantage of these essential benefits, especially preventive and wellness benefits, I have a story that one of our own educators shared with me: A friend’s wife is a nurse and was laid off at her hospital due to budget cuts. Luckily, she was on her husband’s health insurance plan and didn’t have to worry about finding her own. After about three months, she got a job offer to work at an urgent care clinic but before starting, she needed to get a physical because she would be around a lot of sick people and they wanted to make sure she was healthy. During the exam, they found a spot on her lungs. After a biopsy, they found that she had stage 1 lung cancer. It had not yet spread and they were able to remove the spot and part of her lung to make sure they got it all. She is now recovering, is cancer free and is starting her new job at the first of the month. I was told that the health insurance plan paid for almost all the costs, including the x-rays to diagnose, the surgery to remove the spot and then the couple days in recovery she needed before coming home. If she and her family had not had health insurance and if she had not taken advantage of the essential benefit, this health problem would have cost the family thousands of dollars. And if left unidentified, she may not have recovered so quickly. So how does this story relate to the 10 essential benefits? Well, the first doctor’s visit to get the work physical is included in the Preventive and wellness visits part of the essential benefits [CLICK SLIDE TO SHOW]. This is the visit that led the doctor to think something might be wrong with her. From there, the doctor sent her to get lab tests (x-rays) that led to them finding cancer [CLICK SLIDE TO SHOW LAB TESTS]. From there, the doctor sent her to a surgeon to remove the tumor. After the surgery, she needed to stay in the hospital for 3 days [CLICK TO SHOW HOSPITALIZATION] to make sure everything was healing. Both during this and when released, she was given prescription drugs to prevent infection and ease pain [CLICK SLIDE TO SHOW PRESCRIPTION DRUGS]. Finally, after leaving, she was given some medical equipment to help her recover [CLICK TO SHOW SERVICES AND DEVICES]. This is just one way in which one illness used 5 of the 10 essential benefits. The other five benefits are: [CLICK AND SHOW EACH ON AT A TIME ON THE SLIDE] -maternity and newborn care -mental and behavioral health- this includes alcohol, drug and other substance abuse and addiction issues -pediatric care- all vision and dental services are covered until age 18 -outpatient care -emergency room services So why are these 10 benefits important you and to everyone? Health care costs more when health problems are detected in a late stage. For example, if you are diagnosed as diabetic, the care and medicine is a lot more than if they caught it when you were pre-diabetic. So, taking advantage of preventive services can reduce cost of health care. You can prevent, slow down or stop the development of an illness. This means you go to the doctor less, have less medicines, miss less work and many other things. All of this leads to you saving time and money on your health care costs. Finally, if everyone takes advantage of these services, the overall cost of health care to you and your family, as well as the nation as a whole, will be lower. This is because any unpaid healthcare bills are absorbed or paid for by the government. To make up the money, the cost is passed on to you and your family through taxes, fees and other sources. Further, if people wait until they get sick to go to the doctor, the services health insurance has to pay for will be more expensive. This can lead to an increase in premiums you pay. However, if people take advantage of these services, the health care costs will go down. This means that premiums will be less likely to go up and may in fact go down. A report released as the start of open enrollment actually found this to be true. About 80% of the health care plans on the exchanges had no increase or actually lowered their premiums this most recent season. So to be clear, let’s look at our second pitfall: Not Taking Advantage of Essential Benefits.
Potential Pitfall: Not Taking Advantage of Essential Benefits
Consumer Problem: You didn’t realize that the ACA established 10 essential benefits to help consumers be healthy. Consumer Action: Use preventive and wellness services and other essential benefits to your advantage.
Presenter
Presentation Notes
[Click for Problem Header and again for problem statement.]Many of us don’t know that our health insurance plan has to provide 10 essential benefits so we are missing out when we don’t use them So, what do you need to do? [Click for Consumer Action Header and again for action statement.] Use preventive and wellness services to prevent costly health problems…especially those for which you do not make a copayment. Now let’s turn our attention to a third key component using your health insurance—billing.
On average, how many medical bills contain errors?
A. Every bill (100%) B. 8 of 10 bills (80%) C. 3 of 10 bills (30%) D. 1 of 10 bills (10%)
Presenter
Presentation Notes
Let’s play a guessing game: I’m going to ask a question and you’re going to select one of the multiple choice answers: On average, how many medical bills contain errors? A. Every bill (100%); B. 8 out of 10 bills (80%); C. 3 out of 10 bills (30%); or D. 1 out of 10 bills (10%) There are no comprehensive statistics on medical-billing mistakes, but Stephen Parente, a professor of health finance at the University of Minnesota who has studied medical billing extensively, estimates that 30% to 40% of bills contain errors. The Access Project, a Boston-based health-care advocacy group, says it's closer to 80%. Reference: Wall Street Journal Feb. 19, 2011 12:01 a.m. ET online at: http://www.wsj.com/articles/SB10001424052748703312904576146371931841968 If the actual number of errors, or mistakes, is even 50% then every other bill we get may have a mistake! That mistake will likely cost us money. I doubt if anyone wants to “over pay”. Understanding costs is important to be sure that you aren’t overcharged or at least you catch the error before you pay. Controlling and tracking health care costs are often challenging. Most medical bills include errors which makes reviewing your bills and other documents for accuracy very important.
Why Do You Need to Understand Health Care Bills? To make sure you are not
charged for services you did not receive
To make sure you are not overcharged
To make sure you understand the billing process
To prevent Medical ID theft
Presenter
Presentation Notes
We can agree that at least 30% of bills contain errors so if that is the case, we need to know where to look for these errors. Knowing where to look and what you need to know makes controlling costs more manageable. Even though the percent of errors, or mistakes, is not definitive, the likelihood is that there are errors present. It is important to review your bills and Explanation of Health Benefits (EOB) forms to ensure you are not overcharged or that you are not charged for health care services you didn’t receive. There is a concern about medical identity theft – that is people using your medical identity and insurance to have their health cared for. This fraudulent use and subsequent charges would show up on your EOB. So what is an explanation of benefits? It’s the statement Make sure you are not charged for services you didn’t receive and that you are not over charged - It is important that you verify the services your received and confirm charges for those services. There can be mistakes. Understand the billing process - Most health care providers will process an insurance claim but there are some providers who expect you to pay the bill up front. That means you have to file the insurance claim yourself. To do this you will need not only the claim form but the detailed receipt from the health care provider. Prevent Medical Identity Theft - Even though the percent is not definitive, the likelihood that there are errors is present. It is important to review your bills and Explanation of Health Benefits forms to ensure you are not overcharged or that you are not charged for health care services you didn’t receive. Explanation of Benefits are usually sent monthly by your health insurance company. Many people don’t open them; others do but don’t know what to look for or what to do with the explanation. Between medical identity theft – that is people using your medical identity and insurance to have their health cared for and errors, it’s important to be sure those explanations are correct and if not to contact the health insurance company. It’s also important to understand our bill to avoid pitfall #3 - billing errors.
Potential Pitfall: Billing Errors Consumer Problem: You weren’t aware that your bills contained errors so you overpaid. Consumer Action: Check your bill against your receipts and statement of services; then dispute bill if you think there is an error.
Presenter
Presentation Notes
[Click for Problem Header and again for problem statement.] Most of us aren’t aware that many of our health care services bills have errors, or mistakes. We may be overpaying for those services. Overpayment hurts our financial health. So, what do you need to do? [Click for Consumer Action Header and again for action statement.] You need to keep receipts and other documents then compare your bills to those documents. If you find what you think is an error, then you have the right to dispute the bill.
Why Do You Need to Track Health Care Costs? To have the evidence to
dispute errors or denied coverage
To prepare for tax purposes To determine how much to
save for out-of-pocket expenses for next year
To help determine the health insurance plan to choose for next year
Presenter
Presentation Notes
Mia’s Notes: Tracking health care costs is important for a number of reasons. First, having accurate, organized records can save money and reduce frustration. What filing system do you currently use? (Ask for responses). Remind them that everyone has a filing system—some are more useful than others. -------------- Evidence to Dispute Errors - If you need to dispute charges or if you have been denied coverage for a service and need to dispute this decision with the insurance provider or service provider, you will need to keep documents that show the types of service, dates, costs and what you’ve paid as part of the dispute process. Tax Purposes - Health Care costs are a major portion of an individual/family spending plan. The Federal government understands this and has put a limit on the amount an individual/family should pay for unreimbursed medical expenses. These are expenses which are not covered by health insurance, that exceed 10 percent of their adjusted gross income. Anything over this amount could be included as an itemized expense on an IRS schedule A form and deducted from your adjusted gross income. By doing this, it reduces your taxable income amount and therefore your total tax bill. Note to Educator: IRS Publication 502, Medical and Dental Expenses, contains additional information on medical expenses including how you figure and report the deduction on your return. NOTE to Educator: if you are working with Seniors: There is a temporary exemption for individuals age 65 and older until Dec. 31, 2016. If you are 65 years or older, you may continue to deduct total medical expenses that exceed 7.5% of your adjusted gross income through 2016. If you are married and only one of you is age 65 or older, you may still deduct total medical expenses that exceed 7.5% of your adjusted gross income. This exemption is temporary. Beginning Jan. 1, 2017, the 10% threshold will apply to all taxpayers, including those over 65. Saving for Out of Pocket Costs - Another reason to track costs is to determine how much you need to save for out-of-pocket expenses next year. This information will help you build a spending plan that more accurately reflects and prepares for your future health care needs. By building in savings for health care costs, you will reduce your reliance on credit to cover expenses and increase your confidence and capability to cover costs. If you use a tax advantaged saving tool like a Flexible Savings Account or a Health Savings Account, you will have a better understanding of how much to save in these types of accounts. No matter where you stash the savings, it’s important to have an accurate guide to the dollar amount to set aside. Choosing a health insurance Plan for Next Year - You can review the costs of this year’s care to determine if you should choose the same health care plan next year. By reviewing the expenses and also your use of the health care system, you may determine that a different plan would be better for you in the future; especially if your or someone in your family’s health has changed. For all these reasons, understanding your insurance as well as reviewing bills and tracking the costs are important to being a wise health insurance consumer. Now, to bring this session to a close is my colleague, Bonnie Braun.
Your Questions about Using Your Health Insurance?
Presenter
Presentation Notes
As we began this session, we asked you to write down your questions. I’ve looked through them and believe that many were answered. Some were not. Some of you may have new questions. If you want us to get an answer to you, send your question and email address to us. Our email addresses will appear shortly. We will study your questions as we continue to refine our Smart Use Health Insurance curriculum. You may remember that I said at the beginning that we are creating what we think is a three part series focused on accessing health care, controlling costs and tracking costs with appropriate record keeping.
Smart Choice & Smart Use Health Insurance
Presenter
Presentation Notes
As we began this session, we asked you to write down your questions. I’ve looked through them and believe that many were answered. Some were not. Some of you may have new questions. If you want us to get an answer to you, send your question and email address to us. Our email addresses will appear shortly. We will study your questions as we continue to refine our Smart Use Health Insurance curriculum. You may remember that I said at the beginning that we are creating what we think is a three part series focused on accessing health care, controlling costs and tracking costs with appropriate record keeping.
Contact Information:
Bonnie Braun, PHD [email protected] Mia Russell, MBA [email protected] Insuring Your Health http://extension.umd.edu/insure
Presenter
Presentation Notes
As we began this session, we asked you to write down your questions. I’ve looked through them and believe that many were answered. Some were not. Some of you may have new questions. If you want us to get an answer to you, send your question and email address to us. Our email addresses will appear shortly. We will study your questions as we continue to refine our Smart Use Health Insurance curriculum. You may remember that I said at the beginning that we are creating what we think is a three part series focused on accessing health care, controlling costs and tracking costs with appropriate record keeping.
Reliable Resources from the Internet University of Maryland (Health Insurance Literacy
Initiative): http://www.extension.umd.edu/insure/ Ask an Expert:
https://www.extension.umd.edu/insure/health-insurance-literacy-ask-expert
Healthcare.gov: https://www.healthcare.gov/ Consumers Union:
http://consumersunion.org/pub/pdf/healthcare2012.pdf
Presenter
Presentation Notes
For more information, please feel free to use these resources: Navigators or Assisters in your state can help you identify credits that you may be eligible for. Additionally, these professionals are resources you can call upon to discuss penalties based upon your situation. I also encourage you to go the website extension.umd.edu/insure/consumer-resources for more information and an electronic version of My Smart Choice Health Insurance Workbook. I urge you to share this information and the website with friends and family. This site is constantly being updated so feel free to visit frequently. I hope this information and session has been beneficial and that you will be more confident in your health insurance decisions going forward. Thank you again for joining us today. Other Resources: Marylandhealthconnection.gov (MD) -- 410-547-1276 and Attorney General Health Education & Advocacy Unit (MD) 1 (888) 743-0023; http://www.oag.state.md.us/Consumer/HEAU.htm
Acknowledgements
This pilot project was developed with funding from the University of Maryland Extension;
College of Agriculture & Natural Resources Program Development Team
University of Maryland Extension: Bonnie Braun, Virginia Brown, Lynn Little,
Teresa McCoy, Mia Baytop Russell University of Maryland Residential Facilities:
Christine Garcia University of Delaware Extension: Maria Pippidis
Presenter
Presentation Notes
Finally, in addition to Mia and me, there are multiple members of our health insurance literacy initiative team. Without them and the financial support of the University of Maryland Extension and College of Agriculture and Natural Resources, these curricula would not be possible. Hopefully, as we move forward to educate many more consumers, we’ll be able to add communities of practice from AAFCS. Thank you all for attending. I do need to slip away to catch a plane. My new grandbaby is waiting for me to see her and her parents tonight.
