A terrible guide to the terrible terminology of U.S. Health Insurance

I used to be a pharmacy tech (in the US), and the most difficult part of the job BY FAR was dealing with insurance adjudication. Even the name of it tells you how combative the system is. What made the job even harder was patients expecting us to be able to hear the name of the med their doctor wanted to prescribe and what plan they had, and tell them on the spot what their co-pay would be. There are literally thousands of drugs and insurance companies deliberately make it overly complicated. Two people could come in with the same rx, from the same prescriber, with purportedly the same plan from the same employer and have drastically different copays.

Also: If you really want to see red, research being in "the donut hole" on Medicare.

Dude, I'm a foreigner from a developing country and I have a bunch of health problems (though I'm not mentioning them here). I wonder what will happen to me if I one day come to USA for graduate study and permanently working there. 😅 Really, I do have plan to go to USA but, when I learn the sad reality of USA's health system, it's just... Ouch... It makes me think again and again. 😅

Thank you! This has been super helpful!

Marketplace: $10,000 deductible, $800 month premium means ill never vist a doctor and the wellness free visit is a joke.

Thank you Brian, for teaching me more than any school ever has.

Barton Neck

Huh... taking the willfully misleading and maze-like structure of medical ensurance in the US into account, the whole unwillingness to vaccinate during covid, as well as your general mistrust of doctors, makes a LOT more sense!

Can i move to Europe?

This is amazing and as far as I know everything you said was spot on. As an expert in the industry I can tell you that the fucking acronyms are the worst - let alone the plethora of weird counterintuitive definitions. We can’t even train our own healthcare professionals on this crap because it’s obviously built to be extremely confusing. Nowadays I can say with confidence that more than half our patients have no idea what coverage or cost shares they have, let alone the huge amount of special needs (Medicare and/or Medicaid eligible) patients who have NO IDEA what company they are even insured through.
One of the trickiest things is when a patient comes to you and says they have Medicare or Medicaid, and you say OK that’s great, and then later after the claim comes back denied you find out they have some other primary insurance HMO that manages those federal or state benefits. This again is extremely difficult to train staff on so that even your doctor has a difficult time figuring out which payer to bill. It’s total chaos, unless you have the resources and niche experience to know what you’re looking for and how to look for it.

Bernier Ramp

When this video came out, 2 years ago, I saw the first 5 minutes of this video and close it quickly after. It was so complicated and I didnt saw a watching purpouse for me (being from south america).
I just got a job as an interpreter and im mandated by the enterprise to learn the in and outs of all sort of industries, such as inssurance.
I came back, humbled to pay attention to all of these acronyms and concepts, so yeah, thank you

Thank you so much for educating us Brian, I am going to go cry in a bathtub full of cold water now. (Yes my water is off because of my health insurance costs!) <3

Really appreciate this video! Great glossary of terms. Holding onto this for the next time I change my healthcare. I was considering changing my health insurance during this year's open enrollment to save money, but thanks to this video I was able to check my options, run some numbers, and realize that I actually save more staying with what I have because of how changing would impact my current therapist situation! I hope that since making this video your situation has improved- one of my greatest fears about seeking other employment is losing access to my own therapist :(

As a new adult here without healthcare, I am cooked and thoroughly spooked

Holy shit, I did not know how fucking horrible it is

I was glad I have health insurance that covers my mental health because I needed some grippy sock time after I tragically lost the ability to watch the 2015 Richie Rich reboot

I don’t get it

About the ambulance costs. Have a family member drive you if you're not dying. How to know if they're dying: not breathing, no pulse. THAT'S WHEN YOU CALL 911 anything else, and you deserve the giant bill you dummy

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😮

So….. we don’t have affordable health insurance because capitalists love to create new markets that are gate kept by people who specialize in manufacturing bullshit terms to justify their own jobs? So everything about scale of markets is just complex jargon bullshit. Cool, got it.

I’m in medical school and this is actually better than my medical school education on this. Which was none 😅

First video I've seen of yours, just subscribed

As someone who works in Australian private health insurance, what the fuck?

As a 22 year old person constantly in and out of the hospital and ER this is a terrifying video and it did not help my stress

And this is exactly why I haven't had any medical examinations or doctor visits in about 4 years; I'm young and healthy enough although it does suck since I have some nerve issues in my wrist that i literally just cannot do anything about as I dont have enough to get them examined LET ALONE the surgical costs if it were necessary

This is why I ALWAYS call my insurance before I go to the doctor or make any decisions. and I MAKE them explain things to me very clearly. And even then sometimes I don't understand. Or they dont' understand.

I believe that shrooms has opened the door to levels 8 and 9
While on a low non visual dosage it forces my way of thinking at those levels but has allowed me to explore those areas sober as well

Although all the information went above my head but I laughed a lot😂

Aaahhh. Brian David Gilbert here to teach me the things my parents had no time to! 😅

I am 13 and got bored and now this is what I watch when I am bored like right now in the middle of math (I watched this the first day it was released that is why this is my go to thing to watch I think I have watched this 3 times today)

I know most of this by memory

God how horrific

Around 5% maybe?

[This comment is for my own purposes of making a playlist, and is not a judgement of quality.]

Guys as a European this seems like a satirical dystopia

Hermiston Turnpike

In Sweden, we don't have completely free healthcare. I cut my finger up at work and was driven to the ER at nine in the evening, six stitches and emergency care from several doctors. I then recieved the shocking bill of about 20 bucks. We also have a "högkostnadsskydd", literally a protection from high costs. If you get care over a certain amount it kicks in and the rest of the year is free, kind of like your deductibles. It's about 140 bucks where I live. All things considered, I pay just a little more tax than someone at a similar job in the US would.

Kub Avenue

this is unironically one of the best explainers ive ever watched

oh, good. i'll just treat my own injuries

“The free market is more efficient and less bureaucratic” they said

I watched this, thinking "how could it be that difficult"
I think I speak for all of the UK when I say, I have never been happier to have a national health service!

I'm an insurance agent (mostly auto/home and commercial though) but I already knew all of this, I had also never seen a video from this channel... But I still watched the whole thing lol it's that entertaining, I'm checking out a few more

When this video came out, I had just picked insurance at a new job and had all this fresh on my mind. My immediate response was BDG was right on the money with the whole video. Now, I have to shop for insurance again and referenced this video right away because I knew it was the most comprehensive one for me! Thank you for the help BDG!

Wait are any of the free options discussed here, as in states like CA have no asset limit for medicaid and many other states also have full coverage options if you make under a certain amount? This video is great info if you can actually get a career or have money, but I dont know how people are still considering paying for insurance when they cant afford rent or food.

Ahh now THIS!! is one of the reasons I plan to escape this gilded hell as soon as possible!

I'm getting health benefits for the first time in my life and on the day where I'm being introduced to all these terms is the day Dr Go Ogle decided to recommend me this video.
Helpful, but incredibly creepy. Thanks Dr Go Ogle. Please don't do it again.