Health insurance helps protect you from high medical costs by covering part, or sometimes all, of your medical expenses. Your insurance policy lists the medical services, drugs, and tests that the insurance company will and will not cover. The insurance company will then pay for the covered services you receive, while you pay for any uncovered services.
Health insurance is typically obtained through your employer. The plans fall into two groups — Fee for Service and Managed Care, which includes HMO, PPO, and POS plans.
FEE FOR SERVICE
Fee-for-Service, or Indemnity, plans are the traditional type of health insurance. As its name suggests, a Fee-for-Service plan means that the insurance company pays fees for each medical service provided. There are three types of Fee-for-Service plans. Basic Health Insurance covers the cost of a hospital room and care, some hospital services and supplies, and pays toward the cost of surgery and some doctor's visits. Major Medical Insurance covers the cost of basic healthcare plus treatment for long-term, expensive illness or injury, and inpatient and outpatient expenses. Comprehensive Insurance combines Basic and Major into one plan.
Fee-for-Service plans are the most flexible type of health insurance plans. If you are covered by this type of plan, you are free to receive healthcare wherever and whenever you choose. You can receive medical care from any doctor or at any hospital you like. You often have to pay for your medical services up front, and then submit a claim to your insurance company to be reimbursed.
Fee-for-Service plans may also be the most expensive type of insurance plan. People on these plans pay high monthly premiums and deductibles. A premium is the monthly fee you pay to keep your insurance plan in effect. A deductible is the fixed amount of medical costs you have to pay each year before your insurance company starts to pick up the bill. In a Fee-for-Service plan, after you reach your deductible, you then have to split the cost of a medical service with your provider. This is called a co-insurance percentage, which is usually 80/20 or 70/30. The insurance company pays the higher percentage of the bill while you have to pay the rest. Most Fee for Service plans put a "cap" on the amount of medical bills you have to pay in a year. You reach your cap when your out-of-pocket expenses (such as deductibles and co-insurance) total a certain amount. Your insurer will pay the full amount of any covered medical services you receive after you reach your cap.
Managed care plans contract with healthcare providers to provide medical care to members at reduced costs. The goal of managed care plans is to keep costs low by limiting your choice of doctors to those that are "in network," reducing hospital stays, and emphasizing preventive care. HMO, PPO, and POS plans are all considered managed care plans.
One in Ten AMI Patients Have Unrecognized Incident Diabetes
Two New LDL Cholesterol Drugs May Have Big Impact on Heart Disease
COBA Conference Steers Forward in the Fight Against Childhood Obesity
Google Secures Patent for Glucose-Sensing Contact Lens
Medtronic to Use GlucoSitter Artificial Pancreas Software in Future Insulin Pumps - A Big Deal!
Tiramisu Olive and Chick Pea Salad Baked Sweet Onion Dip Wild Rice Soup Herbed Scallops Citrus Spice Cookies Vegetable Noodle Salad Low-Fat Green Bean Casserole Soft Shell Crabs with Asian Mignonette Mediterranean Chopped Salad
This past weekend was a whole lot of diabetes weird. I've finally gotten into a good rhythm with my Lantus rate - settling in with a 70-30 nighttime-morning split of the total dose. My bolus dosing seems to be pretty much on the money too. I'm avoiding huge swings... Though lows are creeping up more often, I think because summer traditionally is a lower basal rate time, owing to warmer weather, increased activity and sweat, as we get closer to the warmer days I just need less insulin in the...