Health insurance can be overwhelming and confusing, but it doesn't have to be.
If you work as a 1099 clinician, you don’t receive any employer-sponsored health insurance coverage from your PRN shifts. It’s up to you whether you want to acquire a health insurance plan and, if so, the type best-suited for you and your family.
This guide is designed to break down basic health insurance terms and provide valuable advice so you can navigate your health insurance options with confidence.
Pro-tip: Did you know that clinicians who pick up shifts on Nursa receive access to supplemental healthcare plans through Hooray Health?
Now, let's turn confusion into clarity and take control of your health insurance journey!
Key health insurance terms
Co-insurance. Deductible. Out-of-pocket maximum.
What does it all mean?
The following definitions will clarify the terms of different health insurance plans and help you make informed decisions.
Premium
The premium is the amount you pay for your health insurance plan, usually every month. It's important to budget for this cost to keep your coverage.
Deductible
The deductible is the amount you have to pay out-of-pocket for covered healthcare services before your insurance starts to pay. While health insurance plans with lower monthly premiums regularly have higher deductibles to satisfy, plans with more modest deductibles frequently are accompanied by higher premiums.
Quite a few choose plans with higher deductibles and lower premiums; however, dealing with an unexpected medical cost can prove quite a challenge. Finding the right balance can help you manage your healthcare costs better.
Copayment (Copay)
A copayment is an amount you pay for a specific healthcare service, like a doctor's visit or prescription medication, at the time of service. Copays can vary depending on the type of service.
Co-insurance
Co-insurance is the percentage of the cost of a covered healthcare service that you are responsible for paying after you've met your deductible. For example, if your co-insurance is 20 percent, you will pay 20 percent of the service cost, and your insurance will cover the remaining 80 percent.
Out-of-pocket maximum
The out-of-pocket maximum is the most you will have to pay for covered healthcare services in a plan year. Once you reach this limit, your insurance will cover 100 percent of the costs for covered services.
Network
A network is a group of healthcare providers and facilities that have contracted with your insurance plan to provide services at discounted rates. In-network providers typically cost less than out-of-network providers.
Explanation of Benefits (EOB)
An Explanation of Benefits (EOB) is a statement from your insurance company that details what services were covered, how much was paid by the insurance, and what you may owe after a claim is processed.
Supplemental insurance
Supplemental insurance refers to additional insurance coverage that helps pay for costs not covered by primary health insurance.
This type of insurance is designed to supplement your existing insurance policy by providing extra benefits or coverage for specific situations, such as accidents, critical illnesses, disability, or hospital stays.
7 tips for navigating health insurance
Now, let’s move beyond the jargon.
If you have health insurance or are considering getting a plan, consider the following tips to get the most benefit from your investment.
1. Review your plan annually
Healthcare needs can change, so it's important to review your insurance needs regularly. Make sure your plan still meets your needs and budget, and look for any changes in coverage or costs.
2. Understand your coverage
Take the time to read through your plan's benefits summary and understand what is covered, what is not, and any limitations or exclusions. This will help you avoid unexpected costs.
3. Use in-network providers
To save money, always try to use in-network providers and facilities. Out-of-network services can be much more expensive and may not be covered at all by your plan.
4. Take advantage of preventive services
Many health insurance plans cover preventive services, like vaccinations, screenings, and annual check-ups, at no extra cost to you. Use these services to stay healthy and catch any issues early.
5. Keep track of your medical expenses
Keep a record of your medical expenses, including receipts and EOBs. This will help you monitor your spending, track your progress toward your deductible and out-of-pocket maximum, and spot any billing errors.
6. Ask questions
If you're unsure about any part of your health insurance plan, don't hesitate to ask questions. Contact your insurance company, healthcare provider, or a healthcare navigator for help.
7. Consider supplemental insurance
Supplemental insurance plans, like those offered through Nursa’s partnership with Hooray Health, can help provide extra coverage for services not fully covered by your primary insurance.
For $40 a month, Hooray Health offers plans that include $0 unlimited telemedicine and $25 urgent care visits to Hooray Health in-network providers. Telemedicine is available 24/7, which means you can access the care you need—anytime, anywhere.
The Sol Lite Plan costs just $15 a month, comes with no deductible, and provides up to $3,000 of coverage per injury. These affordable plans can help lower your out-of-pocket costs and make it easier to plan for everyday healthcare needs.
Remember, knowing your health insurance options can lead to better health and save you money. Get informed and take charge!
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