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Key Medical Insurance Terms for Open Enrollment Review

(The following transcript has not been check by a human for accuracy)

Mon, Nov 07, 2022 1:51PM • 11:44


ridgeway, podcast, deductible, insurance company, pay, covered, darndest thing, doctor, plan, coverage, insurer, ab, preventative care, services, insurance, higher premiums, financial advisors, coinsurance, money, wealth management


Alajahwon Ridgeway

Alajahwon Ridgeway 00:00

You know, we need to drop the stigma of doctors only delivering bad news and we only visit the doctor when things are bad, right? That is the only news we're ever going to get. You know, your primary care doctor is there to keep you healthy. Building a strong relationship with your doctor through communication, and following through with his recommendations or his or her recommendation can save you 1000s of dollars in the long run. As Christians, we were taught to be good stewards over our tithing and giving to the less fortunate. But when it came to our own personal finances and investments, we are clueless on what the Bible says. What does the Bible say about managing debt? leaving a legacy, investing, or even planning for retirement? We answered these and many other questions because we want to teach you how to be rich and righteous. This is your first time to the show you want to say welcome, and you're coming back for another spiritual refill. Welcome back. I am Amy Ridgeway. And this is financial advisors say the darndest thing. Welcome back, my name is Amy Ridgeway, and I'm the host of financial advisors say the darndest things. And my mom's favorite Christian financial advisor. And today, we're going to talk about medical open enrollment. Yeah, it's that time of year, you know, it's Monday morning, you're probably tired from a long weekend, and you open your email to see the dreadful message. Open enrollment, please make your selections. Your heart starts to be fast, you know, it sinks down to the bottom of your shoe, as you barely know the name of your insurance covers that you have, you know, is it Blue Shield, Blue Cross? Is it Blue Cross, no shield, you know, you're thinking in your head isn't Blue Cross Blue Shield? You know, out of frustration, you do the same thing to that email that you do every year. You imagine you never saw it? You know, you you you shut down your email and you go back about your work schedule. Then when your boss asks you, did you see it? Like, yeah, I saw you? No, I'm gonna take care of that, right? Until you see the other message. Open Enrollment last day. So what do you do? Once again, you scramble, you're trying to find the link you you look at last year's options. You're like, God, you know what all that looks good. No changes, boom, you click it, you hit submit, boom, you're done. All right, I'm done. Right. And another year passes, where you don't make any changes. You know, so why don't we do this to ourselves? You know, most of us have been in our careers for 1520 25 years. And we still have that same health insurance coverage options we did when we first started. And the only changes we really make were the mandatory ones made by our insurance company. In all honesty, it is understandable. You know, we tend to fear the things that we don't know. Right. But in our mind, we think well, if it isn't broken, don't fix it. Right? Wrong. You know, our insurance coverage needs to change with our family dynamics, you know, people age, circumstances change and income fluctuates. So you may not know everything there is about health insurance. But I want to give you six terms, you need to know if you want to make a better decision. The first one is premiums. So what a premium is, is this is how much you pay to the insurer monthly for your insurance, premiums may be higher or lower, depending on your employer, where you live. And the plan that you choose, I want you to be very careful about comparing the insurance of let's say, a friend and another state who may have that same insurance company, you're really just opening yourself up for a lot of anxiety, right, because your employer may have a different contract with that insurance company, they may offer different packages for you. So I don't want you to get into a frenzy because your friend pays lower premiums or higher premiums or whatever it may be or have more coverage. So to go payments. This is another one of those buzzwords that you need to know when you're talking about your medical insurance or your health insurance. The this is the amount that you're going to pay for visit is more like a form of cost sharing between you and the insurer and they want to make sure that you're actually putting into some of these insurance coverages and that it's not 100% covered and we'll talk about some of those aspects of coverage that are covered 100% And we'll talk about that a little bit later. But number three is coinsurance. So sometimes a primary insurer won't cover your needs having additional coverage, step in and cover some of those additional costs. Once you've paid your annual deductible may be beneficial if you're a high risk patient You know, maybe you have some prior medical condition that you're constantly going to the emergency room or you constantly need some medical attention, it may be important for you to get some additional coverage to kind of help transfer some of the risk to an insurance company, as opposed to your family taking on that financial burden. The next thing we want to talk about is the deductible. When we talked about coinsurance, we talked about the deductible The annual deductible, so I kind of want to break that down. And what that is, is really the amount that you have to pay before the insurance company starts paying for services. So knowing your plan is crucial for this one, and you may have to do some slight planning. If you have a lower monthly premium, you may have a higher deductible. That means that you have more out of pocket expenses before the insurance company starts cost sharing. And as we talked about that before, we talked about like CO payments and things of that nature. So you need to decide if you're going to pay more on the front end in the form of higher premiums for a month or more on the back end, where you're going to have a higher deductible. So also keep in mind that there are multiple types have deductibles, some for the pharmacy benefits, some are for medical care, and other different services. So make sure to check each deductible to understand your obligation prior to any help. Let's say that your deductible is $2,000, almost like an auto insurance. So if your premium to say $100 a month, but you have to go to the doctor's office, if your deductible is $2,000, you have to pay $2,000 out of your pocket before the insurance company starts cost sharing and things of that nature. So just keep that in mind. Number five is out of pocket maximums, that is the most that you can pay, you paid your premium, the co pays and the deductible, you need to check this number because currently in the Affordable Care Act marketplace, the max out of pocket can't exceed $9,100 for individuals, or 18,200, for a couple. So just make sure that you contact your insurer to double check the Pacific's of your numbers in your plan, and six, you'll hear the term in network and add in network. And I'm going to break this down for you here. If a doctor or service is out of network, it tends to be more expensive. Sometimes this cost can even be double. So make sure that you're checking with your doctor and services that are in preferred networks of your insurer. If not, you can make a request for them to be added. Sometimes they go through sometimes they don't. But it doesn't hurt to try. It all depends on the doctor, the doctor's offices and how they feel about the insurance that you carry. So I want you to keep that in mind when choosing your health insurance, you know, cheaper is not always better. You want to have an honest conversation with your family about your coverage, plan out your doctor visits and make sure that they align with your budget. You know, one key takeaway I want you to have is I want you to see what you are already paying for in your coverage. And most cases, preventative care, such as annual checkups are covered. You know many of us have these wonderful employee benefits and we just don't use them. You know, I've seen some cases where alternative treatments, such as holistic medicine, or maybe even acupuncture was actually covered, you know, but it just takes those extra steps of trying to figure that out. And remember this, you know, the doctors are friend, you know, we need to drop the stigma of doctors only delivering bad news if we only visit the doctor when things are bad, right? That is the only news we're ever going to get. You know, your primary care doctor is there to keep you healthy. Building a strong relationship with your doctor through communication and following through with his recommendations or his or her recommendation can save you 1000s of dollars in the long run. You know picking the right plan and taking advantage of preventative care services is a great way to reduce your risk of greater expenses in the future. You know, we want to not necessarily just heal you. We want to keep you healed. Right? So here's a few words of encouragement you know in today's scripture is comes from Proverbs heavy timbers for us as a Slack hand causes poverty. But the hand of the diligent makes rich and the slack hand is kind of a cool word to say lazy hand. Right? But we you know, we talk about these lazy hands being the cause of poverty. And when we procrastinate or don't put the time into picking the right plan. We are opening ourselves up to this poverty. You know, choosing a medical plan is more than just about money. It's about our health and making sure that you get the most service for the least amount of money. See, but if you don't take advantage of these services, you're simply throwing money away. So what I want you to do, I want you to be diligent, I want you to face that email head on, you know whether you're retired or still working You know, an annual review of your medical covers can position you to keep more money in your pocket and less money in the pocket of the insurance company. Well, hope you've been blessed. My name is Avi Ridgeway, and I'll see you on the other side of your blessing. I hope that you've been blessed as always, this episode was created by AB Ridgeway and owner of AB Ridgeway wealth management, a virtual and in person fee only advisor that believes that financial advice should have gotten in it. If you need help figuring out your finances, feel free to reach out to us at 337-414-3686 or visit our website at WWW dot ABR wealth to schedule a free consultation. new episodes are available every Friday so be sure to subscribe. You can also listen to our podcasts on your favorite platforms, Amazon Music, Spotify, Google podcasts, Apple podcasts, and more or simply visit our website and join our family. I am a B Ridgeway and I'll see you on the other side of your blessing. Alajahwon. Ridgeway is an investment advisor representative and owner of AB Ridgeway Wealth Management LLC, a registered investment advisor which produces a podcast show and makes it available on his website and through other distribution channels. Elijah will rejoin any guests on the podcast and providing their own views and opinion are not necessarily the views and opinions of AB Ridgeway wealth management. Nothing on podcast should be construed as solicitation or offer or recommendation to buy or sell any specific security. Investment Advisory Services are only provides investors to become AB Ridgeway Wealth Management client pursuant to a written Investment Management Agreement. Clients of AB Ridgeway wealth management may hold positions and securities discussed in the podcast. Past performance is no guarantee of future results. All investments involve risk and may lose money. financial advisors say the darndest thing podcast is for informational purposes only and should not be relied on for any investment decisions. Instead, please consult a financial advisor, accountant attorney and or conduct your own due diligence

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Many Christians struggle with the seemingly conflicting views about our faith and the pursuit of financial gain. They were taught that poverty was piety and that a lack of money was the only way to truly detach themselves from the love of money. Our blog debunks some of those claims, teaches you that you can be rich and righteous, and at the same time fulfill your obligation to tithe and give to the less fortunate. We are dedicated to helping you become cheerful givers by organizing your personal finances, providing investment tips to help you create wealth, and encouraging you to create a gifting strategy that will make your family and God proud.

Meet the Author:

A.B. Ridgeway, MBA ( is the owner and Christian Financial Advisor with A.B. Ridgeway Wealth Management. With a decade in the finance industry, his goal is to give believers clarity around the most confusing topic in the Bible, money, and tithing. A.B. Ridgeway helps tithing Christians become cheerful givers but unlocking their money-making potential, so they can prosper and be the great stewards of the wealth God has entrusted them with.

This communication is not intended as an offer or solicitation to buy, hold or sell any financial instrument or investment advisory services. Any information provided has been obtained from sources considered reliable, but we do not guarantee the accuracy or the completeness of any description of securities, markets or developments mentioned. This is strictly for information purposes. We recommend you speak with a professional financial advisor.



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