How a Health Plan Works
Video transcript
Video Transcript: How a Health Plan Works
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The UnitedHealthcare logo stretches into a ribbon that swipes across the screen and flies away.
Narrator:
Welcome in, We've got lots of good info to share with you — so let's get started.
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Welcome
Let's get started
Narrator:
Health plans are designed to help take good care of you. Knowing how they work can help you get the most out of your benefits. Let’s get into it.
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How a health plan works
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A lotus flower, apple, bandage, digital thermometer, smartwatch, blueberry, drug capsule and medical cross nestle into a neat pile.
Narrator:
Most common health plans have a premium, or plan costs, which is a routine payment typically taken out of your paycheck. This helps keep your plan active, so you can stay covered.
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A calendar’s pages flip forward, and a check mark appears on the same day of each month. A hand sets an empty drinking glass next to the calendar.
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At the start of your plan year, you pay 100% of your covered health services until you meet your deductible, which is the dollar amount set by your health plan before it starts to pay costs.
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Your coinsurance may vary by plan or service. This example is for illustrative purposes only. Please refer to your official plan documents for coverage details.
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A hand pours a pitcher of water into a drinking glass. When the glass if half full, a horizontal line appears, labeled “Deductible.” A second hand holding another pitcher of water appears and begins pouring into the same drinking glass.
Narrator:
Once you reach your deductible, co-insurance begins. That’s the percentage of costs your health plan shares with you. For example, you may pay 20% of a covered medical expense, and your plan will pay the remaining 80%.
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Your coinsurance may vary by plan or service. This example is for illustrative purposes only. Please refer to your official plan documents for coverage details.
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Two streams of water fill a drinking glass. The halfway mark of the glass is labeled “Coinsurance.” Water continues to pour into the glass.
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Your plan offers you further protection with an out-of-pocket limit, which is the most you could pay for covered services in a plan year. Typically, coinsurance and deductibles count toward your out-of-pocket limit — but premiums don’t. Once you’ve met the out-of-pocket limit, your plan’s got you covered at 100% when you see network providers for eligible expenses the remainder of the year.
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A drinking glass is filled nearly to the brim with water and ice cubes. At the top of the glass, a horizontal line appears, labeled “Out-of-pocket limit.” Two streams of water begin to pour into the glass. The water rises up to the horizonal line. The top half of the drinking glass is labeled “Coinsurance and deductibles.” The label at the top of the glass changes to “Health plan pays 100%.”
Narrator:
Now let’s take a closer look at your plan.
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Your health plan
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A network is a group of providers and facilities who’ve been con-tracted to deliver health care services, often at a discount. When you get care from network providers and facilities, you’ll save money.
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Network coverage
Save money by getting care from network providers
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A cluster of circles appears. In each circle is a health care-related item, such as a heart, prescription bottle and health care provider. One by one, the circles turn into coins. A piggy bank appears, and the coins drop into it.
Narrator:
Keeping up on preventive care, such as routine wellness exams and certain recommended screenings and immunizations, can help support your overall health.
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A young adult meets with a health care provider in the provider’s office. The provider holds a tablet as they review information together and talk.
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So it’s good to know that preventive care is covered for zero dollars out-of-pocket by most plans when you see network providers.
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An apple and a calendar slide into view on a shelf. A check mark appears on the calendar, and the words “$0 out-of-pocket” appear on screen.
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Your plan may require prior authorization before you receive certain medical services, treatment plans, prescriptions or durable medical equipment. Generally, if you’re receiving services from network providers, your PCP or provider will obtain the prior authorization for you. But, if you go out-of-network, you may be responsible for obtaining it yourself.
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Prior authorization may be required for:
- Certain medical services
- Treatment plans
- Prescriptions
- Durable medical equipment
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A heart, clipboard, prescription medication bottle and wheelchair appear one at a time and then disappear. A cluster of circles appears. In each circle is a health care-related item, such as a heart, prescription bottle and health care provider. The circles are replaced by 2 health care provider circles, which are connected by a dotted line. Three dollar signs appear next to one of the providers.
Check mark
Check mark
Check mark
Check mark
Narrator:
Without getting the prior authorization, you could be responsible for the full cost of the service. Once you're a member, you can check the UnitedHealthcare app or my u-h-c.com for details.
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A young adult types on a laptop computer, pausing to look at a mobile phone.
Narrator:
Now that you know how health plans work, you can get more out of your benefits. Thanks for watching.
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A hot-air balloon drifts upward.
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Once your plan is active, visit my U-H-C.com to browse around and learn more — or sign up for the programs and services that catch your interest.
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Already a member?
Visit myuhc.com
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A ribbon swipes across the screen and becomes the UnitedHealthcare logo.
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Disclaimers are included on screen here, as well as in the video transcript.
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Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by United HealthCare Services, Inc. or their affiliates. Certain preventive care items and services, including immunizations, are provided as specified by applicable law, including the Patient Protection and Affordable Care Act (ACA), with no cost-sharing to you. These services may be based on your age and other health factors. Other routine services may be covered under your plan, and some plans may require copayments, coinsurance or deductibles for these benefits. Always review your benefit plan documents to determine your specific coverage details. B2C EI232689504.3 © 2026 United HealthCare Services, Inc. All Rights Reserved. 23-2211250