Know What your Insurance Protects

Before selecting a policy from an employer menuis eligible for a health savings account.) There are
(or shopping for an individual policy), you should beusually no forms to fill out or bills to keep track
certain you understand the terms used by theof. You are, however, quite limited in your choice
health insurance industry. The meanings can varyof doctors, hospitals, and other health-care
slightly among insurers, so if a number orproviders. You commonly must get a referral
explanation doesn't match up with the followingfrom your primary-care physician to see a
definitions, press the insurance provider for morespecialist; if you don't, your treatment with the
details; there may be costs or exceptions hiddenspecialist is not covered. Though HMOs were
in the differences in jargon.designed to control costs, they have been the
Coinsurance is the amount you must pay aftersource of many consumer complaints. These
your health plan's deductible has been met. It'scomplaints were often because of coverage
usually expressed as a percentage. For instance,limitations or the fact that some doctors were
you might have to pay 20 percent of every billcompensated for denying treatment or referrals
until the total of your own payments hits yourto patients or punished for providing what was
out-of-pocket maximum.considered by the HMO to be excessive
Copayment is a flat fee you pay for health-caretreatment, although both problems have lessened
services, regardless of how much the doctor orin recent years. Because of their comprehensive,
hospital receives from your insurance provider.deductible-free coverage, HMOs often compete
Some plans, especially HMOs and some PPOs,with the most affordable health insurance options.
require a copayment, usually $10 to $30 for eachAn HSA (health savings account) is a less
office visit to a doctor and often higherexpensive, high-deductible policy linked to a
copayments for emergency care.tax-free savings account that can be used to pay
Credit for prior coverage may be something youmedical bills before the policy's deducible is met.
need to prove -- normally with a letter from yourLifetime maximum is the maximum amount of
former insurer -- if you are switching employerscovered expenses your insurance company will
or insurance plans and need preexisting conditionspay in your lifetime. Look for a policy with a
to be covered right away. This is especiallylifetime maximum of at least $3 million.
important if you are buying an individual policy,Out-of-pocket maximum is the amount of
which can have a waiting period for preexistingcoinsurance you must pay yourself before an
conditions.insurance policy will pay 100 percent of your bills.
A deductible is the amount you must pay forIt may or may not include the deductible. The
your medical bills before your insurance kicks in.term stop-loss is sometimes used to refer to the
Usually the higher the deductible runs, the lesspoint at which you have met your deductible and
expensive the policy is.paid your out-of-pocket maximum.
EOB (explanation of benefits) is a statement fromA POS (point-of-service) plan is like a PPO except
your insurance company showing what it has paidthat you need a referral from your primary-care
and not paid for a claim. Some companies resistphysician to see an out-of-network doctor, for
supplying duplicate EOBs, so maintaining anwhich you may have to pay extra. Without the
organized file of your EOBs is important if youreferral, you will likely have to pay the entire bill
need to challenge a bill.for the out-of-network physician.
An EPO (exclusive provider organization) planA PPO (preferred provider organization) plan is a
allows you to use any doctor or hospital withincross between a fee-for-service plan and an HMO.
the insurance provider's current network, withoutYou can see any doctor you choose without a
a referral. You have no coverage, however,referral, although if the physician is outside the
outside the current network even if your doctorinsurance plan's network you will probably be
used to be included in the plan. There can bereimbursed at a lower rate. For network doctors,
copayments similar to those for HMO and PPOyou usually have only a copayment for office
plans.visits. There can be varying copayments -- as well
A fee-for-service (indemnity) plan is the traditionalas deductibles, coinsurance, and out-of-pocket
kind of healthcare policy that allows you to go tomaximums -- depending on the policy. Most plans
any doctor or hospital you choose. Deductiblesthat are eligible for use with a health savings
can range from several hundred to severalaccount are PPOs with a high deductible tacked
thousand dollars. After you have paid bills totalingon.
your deductible, the plan usually pays 80 percentThese terms, of course, aren't exclusive to
of all bills; you pay the other 20 percent up to anindividual policies. Many employers offer a menu of
out-of-pocket maximum that generally runsplans for you to select from that usually includes
between $1,500 and $3,000. After you haveHMOs, PPOs, and traditional indemnity plans.
reached the out-of-pocket maximum, the policyIncreasingly, companies are offering HSAs and
pays 100 percent of your medical expenses. Indropping indemnity plans because they are so
most states, fee-for-service is the mostexpensive.
expensive health insurance you can 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 a monthlyAffordable Coverage by Fred Brock. Copyright
premium, the HMO provides comprehensive care.© 2006 Fred Brock. Published by Times
You likely pay a copayment for office visits, butBooks; October 2006;$15.00US/$20.00CAN;
most HMO plans have no deductibles. (The0-8050-7980-7.
exception to the no-deductible rule is an HMO that