FixKit AI

Loop/Prompt Library / Learn: Healthcare

๐Ÿ’ฌ AI prompt: The four numbers that decide what you pay

Your plan has a monthly fee, a starting amount you pay first, then a share you split, and a yearly limit after which the plan pays everything.

Copy this prompt

I'm pasting my health plan's Summary of Benefits and Coverage below with personal details removed. Make a plain-English cheat sheet: premium (if listed), deductible (individual and family), out-of-pocket maximum, copays and coinsurance for primary care, specialists, urgent care, ER, labs, imaging, and each drug tier. Note anything that says 'not subject to deductible'. Quote the document for each number and say 'not stated' if it isn't there. Do not give me medical, legal or financial advice and do not diagnose anything. Stop after the cheat sheet.

[paste SBC text]

How to use it

  1. Open Grok Bot, ChatGPT, Gemini or Claude โ€” any of them works.
  2. Paste the prompt and fill in every [bracket]. Black out names, account numbers and member IDs first.
  3. Read the answer and double-check anything important before you act on it.

Not medical, legal or financial advice. The AI drafts; you decide and you press send.

Read the card โ†’

More prompts like this

One-minute challenge: Healthcare

Your first try at using AI on this topic.

In network vs out of network

'In network' means the doctor has a price deal with your insurance; 'out of network' means they don't, and you can end up paying much more.

Read your EOB before you pay any bill

The 'Explanation of Benefits' letter from your insurance shows what you really owe, so check it before paying the doctor's bill.

Know what kind of plan you have

Who makes the rules for your insurance โ€” your state, your employer, or Medicare โ€” decides where you complain when something goes wrong.

What prior authorization really is

Prior authorization means your insurance wants your doctor to prove you need a medicine or test before they'll pay for it.

Rung 1: peer-to-peer and a resubmission

Before a formal appeal, your doctor can call the insurance company's doctor and explain why you need the treatment.