How health care system works


Know What your Insurance Protects

Before selecting a policy from an employerthe no-deductible rule is an HMO that is
menu (or shopping for an individual policy),eligible for a health savings account.) There
you should be certain you understand theare usually no forms to fill out or bills to
terms used by the health insurance industry.keep track of. You are, however, quite
The meanings can vary slightly amonglimited in your choice of doctors, hospitals,
insurers, so if a number or explanationand other health-care providers. You commonly
doesn't match up with the followingmust get a referral from your primary-care
definitions, press the insurance provider forphysician to see a specialist; if you don't,
more details; there may be costs oryour treatment with the specialist is not
exceptions hidden in the differences incovered. Though HMOs were designed to control
jargon.costs, they have been the source of many
consumer complaints. These complaints were
Coinsurance is the amount you must pay afteroften because of coverage limitations or the
your health plan's deductible has been met.fact that some doctors were compensated for
It's usually expressed as a percentage. Fordenying treatment or referrals to patients or
instance, you might have to pay 20 percent ofpunished for providing what was considered by
every bill until the total of your ownthe HMO to be excessive treatment, although
payments  hits  your  out-of-pocket  maximum.both problems have lessened in recent years.
Because of their comprehensive,
Copayment is a flat fee you pay fordeductible-free coverage, HMOs often compete
health-care services, regardless of how muchwith the most affordable health insurance
the doctor or hospital receives from youroptions.
insurance provider. Some plans, especially
HMOs and some PPOs, require a copayment,An HSA (health savings account) is a less
usually $10 to $30 for each office visit to aexpensive, high-deductible policy linked to a
doctor and often higher copayments fortax-free savings account that can be used to
emergency  care.pay medical bills before the policy's
deducible  is  met.
Credit for prior coverage may be something
you need to prove -- normally with a letterLifetime maximum is the maximum amount of
from your former insurer -- if you arecovered expenses your insurance company will
switching employers or insurance plans andpay in your lifetime. Look for a policy with
need preexisting conditions to be covereda  lifetime  maximum  of at least $3 million.
right away. This is especially important if
you are buying an individual policy, whichOut-of-pocket maximum is the amount of
can have a waiting period for preexistingcoinsurance you must pay yourself before an
conditions.insurance policy will pay 100 percent of your
bills. It may or may not include the
A deductible is the amount you must pay fordeductible. The term stop-loss is sometimes
your medical bills before your insuranceused to refer to the point at which you have
kicks in. Usually the higher the deductiblemet your deductible and paid your
runs,  the  less  expensive  the  policy  is.out-of-pocket  maximum.
EOB (explanation of benefits) is a statementA POS (point-of-service) plan is like a PPO
from your insurance company showing what itexcept that you need a referral from your
has paid and not paid for a claim. Someprimary-care physician to see an
companies resist supplying duplicate EOBs, soout-of-network doctor, for which you may have
maintaining an organized file of your EOBs isto pay extra. Without the referral, you will
important  if  you  need to challenge a bill.likely have to pay the entire bill for the
out-of-network  physician.
An EPO (exclusive provider organization) plan
allows you to use any doctor or hospitalA PPO (preferred provider organization) plan
within the insurance provider's currentis a cross between a fee-for-service plan and
network, without a referral. You have noan HMO. You can see any doctor you choose
coverage, however, outside the currentwithout a referral, although if the physician
network even if your doctor used to beis outside the insurance plan's network you
included in the plan. There can be copaymentswill probably be reimbursed at a lower rate.
similar  to  those  for  HMO  and  PPO plans.For network doctors, you usually have only a
copayment for office visits. There can be
A fee-for-service (indemnity) plan is thevarying copayments -- as well as deductibles,
traditional kind of healthcare policy thatcoinsurance, and out-of-pocket maximums --
allows you to go to any doctor or hospitaldepending on the policy. Most plans that are
you choose. Deductibles can range fromeligible for use with a health savings
several hundred to several thousand dollars.account are PPOs with a high deductible
After you have paid bills totaling yourtacked  on.
deductible, the plan usually pays 80 percent
of all bills; you pay the other 20 percent upThese terms, of course, aren't exclusive to
to an out-of-pocket maximum that generallyindividual policies. Many employers offer a
runs between $1,500 and $3,000. After youmenu of plans for you to select from that
have reached the out-of-pocket maximum, theusually includes HMOs, PPOs, and traditional
policy pays 100 percent of your medicalindemnity plans. Increasingly, companies are
expenses. In most states, fee-for-service isoffering HSAs and dropping indemnity plans
the most expensive health insurance you canbecause  they  are  so  expensive.
buy.
Reprinted from Health Care on Less Than You
An HMO (health maintenance organization) isThink: The New York Times Guide to Getting
essentially a prepaid health plan. For aAffordable Coverage by Fred Brock. Copyright
monthly premium, the HMO provides© 2006 Fred Brock. Published by Times
comprehensive care. You likely pay aBooks; October 2006;$15.00US/$20.00CAN;
copayment for office visits, but most HMO0-8050-7980-7.
plans have no deductibles. (The exception to



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