Section 14 - HOSPITALIZATION AND HEALTH INSURANCE

1 - HEALTH MAINTENANCE ORGANIZATION

Expenses in this type of plan are usually covered in full or there is a modest co-payment at the time of your visit. There are two basic types of HMO’s. The first is the group/staff type in which you go to a central facility (group health center) to receive care. The second type is an independent practice association (IPA) in which providers work from their individual offices and are referred to as primary care physicians.

2 - FEE FOR SERVICE PLAN

In a fee for service type of plan you or your insurance company is generally billed after each visit. In a traditional fee for service plan you may go to any doctor or hospital you choose. In a Preferred Provider Organization (PPO) you are provided with a list of doctors from which you may choose. If you choose to go to one of the doctors on the PPO list, the amount of expenses covered is higher than if you go to a doctor not on the list.

3 - COMMERCIAL MEDICARE SUPPLEMENT

A Commercial Medicare Supplement is a voluntary contributory private insurance plan available to Medicare recipients, to cover the costs of deductibles, coinsurance, physician services and other medical and health services.

4 - SPECIAL PURPOSE PLAN

A special purpose plan is one which covers only specific health needs. Examples of special purpose health insurance plans are -

  Dental Insurance   Mental Health Insurance
  Vision Insurance   Dread Disease Policy
  Prescription Drug Insurance

 

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Go back to Section 14, Part C »

 

Last Modified Date: January 5, 2005