Name: In-Network vs Out-of-Network Explained by Under The Coverage
Duration: 11 min 23 s
Description: You always hear that you need to look for an in-network provider but do you really know why? In this episode, we explain how provider networks work, why staying in-network can save you money and how to identify what your costs might be if you choose to see an out-of-network provider.

💸 Ever wonder why your medical benefits cost an arm and a leg? Join Jolene and Sara in this short and lively episode as they dive into the reasons behind the high price tags on insurance premiums in the United States.

This episode unpacks:
•	The average annual cost of coverage in the United States.
•	The pros and cons of cutting-edge treatments and pricey new drugs.
•	The role of chronic diseases and an aging population in driving up costs.

Get ready for a quick, engaging, and informative discussion that makes sense of the dollars and cents behind your medical benefits. Hit play to become a smarter healthcare consumer!

Subscribe now and never miss an episode of healthcare know-how! 🎧💡

Breaking Down Insurance Premiums for Medical Benefits

🩺 Ready to take control of your health? Join Jolene and Sara for a quick, fun, acronym-filled dive into the world of preventive services, zero dollar copays and the ACIF and USPSTF! In this short episode, you'll learn why preventive care is essential and how the Affordable Care Act (ACA) guides your zero copay benefits. 

We'll cover: 
- Who is the USPSTF and the ACIP? 
- What’s considered preventive 
- Key screenings, counseling, vaccines and medications you should know about. 
- How the Affordable Care Act (ACA) helps cover these preventive services. 

Tune in to get the scoop on keeping healthy, making informed choices, and ensuring you’re getting the preventive services you need—all with a smile and a bit of fun! Don’t miss out—hit play now and start your journey to better health! 🎧✨ 

Links to learn more:  
Looking for quick access to the USPSTF A&B Recommendations? https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations 

Find ACIP recommendations and guidelines for vaccines https://www.cdc.gov/vaccines/?CDC_AAref_Val=https://www.cdc.gov/vaccines/hcp/acip-recs/index.html#print 

Understanding the ACIP & How Vaccine Recommendations are Made in the US https://www.youtube.com/watch?v=WWf4xVw1-PE

Preventive Services 101

🩺Ever been faced with a scary, serious health situation and felt overwhelmed and unsure of where to turn for help? In this moving episode, we hear from Allison, a former patient whose life was profoundly impacted by the care and support provided by one of  Nova's case management nurses. Allison recounts her journey, starting from the surprise of learning she was pregnant with twins to navigating a complicated pregnancy, serious health condition of one of her babies, and insurance challenges while out of state for specialized care. 🚼
🔑Episode highlights include:  
- The role of nurses in health insurance
- How to stay organized and proactive to help better manage care
- The importance of mental health and well-being when dealing with serious health diagnoses
Allison shares her deep gratitude for the support she received, including nominating her case manager for a regional excellence award, which she won. The episode beautifully highlights how a compassionate case manager can make all the difference during medical crises.  Tune in to hear about how the unique benefits of having knowledgeable nurses from the insurance side involved in the process, and how their understanding of both medical and insurance landscapes can play an instrumental role in guiding you through your most stressful health situations. 🎧

The Power of a Caring Nurse in Your Corner

🚑 Ever wondered why a quick trip to the ER or a ride in an ambulance can lead to a shocking bill in your mailbox? In this episode, we break down everything you need to know about emergency services and the costs that come with them. From understanding when to dial 911, to the hidden fees that could catch you off guard, we’ve got you covered. We’ll also dive into the No Surprises Act—what it protects you from, and where it falls short—especially when it comes to those pricey ambulance rides. Whether you're trying to avoid financial surprises in an emergency or just want to be better prepared, this episode is a must-listen. Tune in and take control of your health care costs before the unexpected happens! 

🔑 Episode Highlights: 
- When to Use Emergency Services: Clear guidance on when to head to the ER vs. seeking care elsewhere. 
- Breaking Down Costs: A look at the fees you can incur
- The No Surprises Act: What it covers, what it doesn’t, and how it impacts your emergency bills. 
- Avoiding Financial Shocks: Tips on how to protect yourself from unexpected charges in an emergency. 
- Advocating for Yourself: Practical advice on negotiating bills and ensuring you’re only paying for what you need. 
- Join us for a crash course in understanding emergency care costs—before you're faced with the bill! 🚑💡 

Subscribe now and never miss an episode of health benefits know-how!

The Price of Panic: What you need to know about ER Expenses

It’s that time of year again, open enrollment season! If you (or your spouse) are the subscriber for your health insurance, chances are you’ll be hearing from your HR team soon with reminders to review your benefits. But did you know there are also certain life events, like getting married, having a baby, or changing jobs, that let you make changes to your coverage outside of the open enrollment window?

In this episode, we break down the basics of choosing and updating your benefits, so you feel confident about your options when it matters most.

Want more? Check out our earlier conversation with Carey about what happens when you age off your parent’s health plan: https://www.youtube.com/watch?v=T3xP8x5zjBw&list=PL78gefbzNivQBmnlgBkdyo_mL9KP3nz6G&index=38.

How and When to Make Changes to Your Benefits

Trying to figure out which health plan is best for you? In this episode, we break down the key differences between copay-based plans and high-deductible health plans (HDHPs), and explain how provider networks can impact your choices. Whether you’re comparing premiums, thinking about out-of-pocket costs, or wondering which plan fits your lifestyle, we’ll give you the tools to make a smarter, more confident decision this enrollment season.

It’s Open Enrollment: Which Health Plan Should I Pick?

Wondering how to use an HSA or FSA—or decide which one is better? In this episode, we break down the rules, tax savings, and pros and cons of each so you can take advantage of these powerful benefits.

What’s the Difference Between an HSA and an FSA?

You always hear that you need to look for an in-network provider but do you really know why? In this episode, we explain how provider networks work, why staying in-network can save you money and how to identify what your costs might be if you choose to see an out-of-network provider. 

In-Network vs Out-of-Network Explained

Still confused by the difference between a deductible, copay, and coinsurance? You’re not alone. In this episode, we break down the health insurance terms that show up on nearly every benefit plan. We’re here to help you figure out what you’re spending where so you can make the best decision for you and your wallet. If you’re looking for even more information, check out our previous episode: https://youtu.be/47bJ6iU97jI?feature=shared 

Deductibles, Copays & Coinsurance - Health Insurance Terms You Should Know

We talk to people who work behind the scenes but are also consumers of healthcare. We ask them what they know now that they wish every healthcare consumer knew. Find us on Twitter @UndrTheCoverage or send us a question to podcast@novahealthcare.com

In-Network vs Out-of-Network Explained

Under The Coverage

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