2. Insurance
It is a product that you buy that helps you pay major
expenses at a later date
Types: Car/Life/House/Health
Every type of insurance has:
Covered Person
Provider
Co Insurance
Co Payment (Co-Pay)
Premium, Deductible and Stop-Loss Limit
3. Health Insurance
What it does for you?
What if you get sick? In an accident and have to go to
the emergency room?
Would you want to have Health Insurance?????
4. What if you choose not to have
Health Insurance
Pay for 100% of expenses
Only able go to the emergency room
Most Doctors won’t accept you as a patient without
insurance
5. Why do people choose not to have
health insurance
Don’t understand how it works
Not offered through employer
Don’t think they need it
Don’t think it is worth the cost of premium
6. Where do you get Health Insurance
Employer
Independent licensed insurers
Government Programs
Medicaid
Medicare
7. How do you use Health Insurance
Similar to a Drivers
License
Will make photo copy
for records
Will show important
information
Covered person
Coverage type
Co – Pay
Customer Service contact
information
8. PPO vs HMO
PPO (Preferred Provider Organization)
Economic Incentives to contact certain providers
If go out of network, amount PPO pays will change
(usually less)
HMO (Health Maintenance Organization)
Similar to major medical policy
Must see Primary Care Physician (PCP) for the HMO to
pay expenses
9. Scenario One
Nathan’s Health Nathan has a
Insurance Policy skateboarding accident
$250 deductible His medical bills total
80/20 co-insurance $ 40,250
$2,000 stop-loss limit How much does Nathan
$1,000,000 limit of pay?
policy $ 650
How much does the
insurance company pay?
$ 39,600
10. Breaking it Down
$40,250 Cost of accident $2,000 Stop Loss Point
- 250 Deductible x 0.20 Nathan’s Co Ins.
$40,000 $400
- 2,000 Stop-Loss Limit
$38,000 Stop-Loss Met $2,000 Stop Loss Point
x 0.80 Insurance Co’s %
$1600
11. Breaking it Down
Nathan Pays Insurance Co. Pays
$250 Deductible $0
$400 Co-Insurance $1,600
$0 Stop Loss Point Met $38,000
$650 Total $39,600
