A deductible is the amount that you have to pay for your health care each year before your insurance starts paying for your care. Similar to car insurance, many health plans require you pay a certain amount out-of-pocket before the coverage kicks in. For example, if you have a deductible of $1500 you have to pay the first $1500 of your medical costs before your insurance starts paying. In some plans the deductible applies only to services that you get outside of the provider network. Also, some plans have a separate deductible for prescription medications. Usual deductible does not apply for preventive services.

An Out-Of-Pocket Limit is the most that you're going to have to pay each year for care covered by your plan. Once you hit that limit your insurance starts paying for all of your covered costs. Now if you have other family members on the same plan they have to meet their own out-of-pocket limits until the overall family out-of-pocket limit has been met as well. Some things that are not counted towards the out-of-pocket limit those can include your premiums, balance billing charges, and health care that the plan does not cover.

The money that you pay out-of-pocket for the services that you receive. This could include anything from an office visit to the doctor, prescription medicine, an x-ray, or even a hospital stay.
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Now if the money you pay is a set amount that would be called a co-payment or a copay. If the money that you pay is a percentage of the cost then that would be called coinsurance. Now depending on the plan that you have it dictates whether you have a co-payment/copay or coinsurance.

​Health insurance is divided into four main categories. Each category has the name of a metal, the more expensive the metal the more expensive the premium but the richer the benefits. Bronze for example covers 60% of your medical expenses it is also the least expensive premium. Silver covers 70%, Gold covers 80% and Platinum, the most expensive tier, covers 90%.

A health insurance premium is the amount of money you pay per month to the health insurance carrier. Now, you either pay by the month of you pay it per pay period depending if you get it through your employer or not.
 
If you get it through your employer, your employer most likely covers a portion of your premium.
 
If you get your insurance through either Covered California or through the exchange in another state then you most likely get an Advance Premium Tax Credit, that's where the Federal Government pays a part of your health insurance premium for you.
 
If you are not on the exchange and you buy directly through the carrier then you're paying 100% of the premium yourself.

Have an insurance question? Drop it in the comments and it might become the next video!

​The term "vision insurance" is commonly used to describe health and wellness plans designed to reduce your costs for routine preventive eye care and prescription eyewear such as eyeglasses and contact lenses. Some vision plans also offer discounts on elective vision correction surgery, such as LASIK and PRK.
 
You can get vision insurance in one of two ways: as a standalone plan or as combined with your dental plan.
 
Going to the doctor, going to the dentist—all part of taking care of your health. But going to the eye doctor? Also important! Eye exams at every age and life stage can help keep your vision strong. Many people think their eyesight is just fine, but then they get that first pair of glasses or contact lenses and the world comes into clearer view—everything from fine print to street signs.

​Only Your Eye Doctor Knows for Sure
Eye diseases are common and can go unnoticed for a long time—some have no symptoms at first. A comprehensive dilated eye exam by an optometrist or ophthalmologist (eye doctor) is necessary to find eye diseases in the early stages when treatment to prevent vision loss is most effective.
 
During the exam, visual acuity, depth perception, eye alignment, and eye movement are tested. Eye drops are used to make your pupils larger so your eye doctor can see inside your eyes and check for signs of health problems. Your eye doctor may even spot other conditions such as high blood pressure or diabetes, sometimes before your primary care doctor does.
 
Vision Care Can Change Lives
Early treatment is critically important to prevent some common eye diseases from causing permanent vision loss or blindness:
-Cataracts (clouding of the lens), the leading cause of vision loss in the United States
-Diabetic retinopathy (causes damage to blood vessels in the back of the eye), the leading cause of blindness in American adults
-Glaucoma (a group of diseases that damages the optic nerve)
-Age-related macular degeneration (gradual breakdown of light-sensitive tissue in the eye)

​Why get a vision insurance plan?
-Protect your eye health. Routine vision care may not be covered by your health plan.
-Save money. A vision insurance plan may reduce your out-of-pocket costs for eye care.
-Maximize benefits. Receive discounts on vision expenses like glasses or even LASIK.
-Get personalized service.
 
The two popular Vision Insurance Carriers in California are VSP and Humana.

HMO - Health Maintenance Organization
An HMO is a type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. You will usually need a referral from your Primary Care Physician to see a Specialist, resulting in multiple co-pays. All healthcare services are managed in-network through your Primary Care Physician.​

​In California, the popular HMOs are Kaiser Permanente, Sutter Health Plus, Western Health Advantage, Health Net of California, Sharp Health Plan, LA Care, Molina Healthcare, and Valley Health Plan.

PPO - Preferred Provider Organization
A PPO is a type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan’s network. You can use doctors, hospitals, and providers outside of the network for an additional cost. PPOs do not require you to select a Primary Care Physician. One of the benefits of a PPO is you usually can self-refer to a Specialist.
 
In California, the popular PPOs are Blue Shield of California, Health Net Life Insurance Company, and Oscar.

EPO - Exclusive Provider Organization
A managed care plan where services are covered only if you go to doctors, specialists, or hospitals in the plan’s network (except in an emergency). Under an EPO plan you do not choose a Primary Care Physician. You can receive care from any of the in-network doctors and self-refer to in-network specialists.
 
In California, the popular EPOs are Anthem Blue Cross, Health Net Life Insurance Company, and Oscar.