How US Health Insurance Works In USA

Thank you for calling Big Health Insurance Company Incorporated. How can I help you today?
Hi, I’m just trying to figure out why you guys didn’t pay for my hospital bill.
Oh, well it appears you have not met your deductible yet.
But I pay $300 a month for health insurance.
Oh, that’s your insurance premium.
Well, then what do I get for my premium?
You get the opportunity to pay your deductible.
Okay, so once I pay my deductible, then you’ll pay for all my health care?
Yes, sir. Except for your co-insurance.
Oh yeah, I have to pay that every time I go see the doctor.
Oh no, that’s your co-pay. I’m talking about your co-insurance.
Well, what’s co-insurance?
That’s the percentage of every medical bill that you have to pay.
Even after I’ve met my deductible?
Yes, sir.

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And even though I pay my premiums every month?
Yes, sir.
Is there ever a point when the health insurance I pay for pays for my health care?
Well, you do have an out-of-pocket maximum, which is the most money you’d have to pay in a calendar year.
Oh, well, that’s good.
You just have to make sure all the hospitals you go to and the doctors you see are in-network.
What? Why?
Because any out-of-network charges don’t apply to your insurance plan.
Well, how do I know what’s in-network and what’s out-of-network?
Oh, we try to make that information as difficult to find as possible.
Well, that’s just great.
Is there anything else I can help you with?
Oh yeah, I noticed you added a $50 service charge on my bill. What is that for?
Oh, that’s a charge for you calling us today.

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