Health Insurance Changes
[Health insurance changes are in large part the result of medical claims cost inflation far exceeding ordinary inflation. As the cost of medical care increases and consequently claims costs, health insurance changes occur as insurers look for new ways to contain costs. There are also health insurance changes in the form of new plan designs. – ed.]
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?
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.
Next - Choosing Health Insurance Return to Contents - Health Insurance
[Health insurance changes occur in response to consumer demand and the need to at least break even and stay in business. Notable health insurance changes include the introduction of PPO networks for more efficient claims processing. More health insurance changes occurred in the form of the HMO in an attempt to stop waste of medical resources. As medical inflation continues unabated, even more radical health insurance changes than the transition from indemnity to managed care may be necessary. – ed.]