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Health care in America is changing rapidly. Twenty-five years ago,
most people in the United States had indemnity insurance coverage.
A person with indemnity insurance could go to any doctor, hospital,
or other provider (which would bill for each service given), and
the insurance and the patient would each pay part of the bill.
But today, more than half of all Americans who have health insurance
are enrolled in some kind of managed care plan, an organized way
of both providing services and paying for them. Different types
of managed care plans work differently and include preferred provider
organizations (PPOs), health maintenance organizations (HMOs), and
point-of-service (POS) plans.
You've probably heard these terms before. But what do they mean,
and what are the differences between them? And what do these differences
mean to you?
Overview:
This booklet can help you make sense of your choices for getting
health care insurance:
See the questions and answers on important things you should know
when "Choosing
a Plan."
To get the most out of the plan you choose, see the tips in the
section "Using
Care."
For more help, see "Sources
of Additional Information."
Even if you don't get to choose the health plan yourself (for example,
your employer may select the plan for your company), you still need
to understand what kind of protection your health plan provides
and what you will need to do to get the health care that you and
your family need.
The more you learn, the more easily you'll be able to decide what
fits your personal needs and budget.
"Choosing and Using a Health Plan"
Agency for Healthcare Research and Quality,(10 Aug. 2006)
http://www.ahrq.gov
<http://www.ahrq.gov/consumer/hlthpln1.htm>
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