Cliffsnotes Understanding Health Insurance

✍ Scribed by Darlene Brill

• Year: 1999
• Tongue: English
• Leaves: 130
• Category: Library

✦ Synopsis

Cliffs Notes: Understanding Health Insurance is the best beginning guide to navigating the alphabet soup of health care today. Learn the difference between HMOs, PPOs, POSs and other managed care plans. Find out how to determine which plan is for you and how to make the most of the care offered by your employer. CliffsNotes: Understanding Health Insurance provides expert advice on costs, coverage, claims, consumer rights and more. From your COBRA plan to Blue Cross / Blue Shield, this book will give you the details on the plans offered by major carriers. Filled with information and expert tips on deciphering the language of health insurance. Discover how to distinguish from the many kinds of health care from PPOs to HMOs and beyond. Features advice on dealing with the red-tape of insurance paperwork. 71 percent of Americans under 65 have private health insurance coverage. (Human Ecology Forum, June 22, 1997)

✦ Table of Contents

CliffsNotes™ Understanding Health Insurance......Page 1
Table of Contents......Page 5
How to Use This Book......Page 9
Don't Miss Our Web Site......Page 10
CHAPTER 1: EVALUATING YOUR HEALTH INSURANCE PLAN......Page 11
Group Health Insurance Plans......Page 12
Buying an individual plan......Page 13
Understanding costs......Page 14
Fee-for-Service Plans......Page 15
Basic coverage......Page 16
Major medical coverage......Page 17
Understanding costs......Page 18
Health maintenance organization (HMO)......Page 20
Preferred provider organization (PPO)......Page 22
Definitions......Page 24
COBRA......Page 25
Paying for a Plan......Page 27
Small groups......Page 28
Paying Your Part with Copayments......Page 29
Sharing Costs: Deductibles and Coinsurance......Page 30
Maximum out-of-pocket......Page 31
Using Pretax Dollars: FSAs......Page 32
Reasonable and Customary Fees......Page 36
Preventive Care......Page 39
Maternity Care......Page 40
Infertility Treatment......Page 41
Government regulations......Page 42
Medical Tests and X Rays......Page 43
Hospital Care......Page 44
Pre-Existing Conditions......Page 45
Health Insurance Portability and
Accountability Act (HIPAA)......Page 46
Setting limits for exclusions......Page 47
Providing better access to individual
coverage......Page 49
Certifying a Medical Procedure......Page 50
Alternative Care......Page 51
Dental Care......Page 53
Routine restorative care......Page 55
Oral surgery and orthodontia......Page 56
Vision Care......Page 58
Dread Disease Insurance......Page 60
Shopping for a plan......Page 61
Paying the price......Page 62
Catastrophic Coverage and Long- Term Care......Page 63
Home health care......Page 64
Disability......Page 65
Long-term disability (LTD)......Page 66
Formularies......Page 69
Prescription drug card program......Page 70
Mental Health Care......Page 71
Hospital Indemnity Insurance......Page 72
Short-Term Health Plans......Page 73
Dialing for details......Page 74
Determining eligibility......Page 75
Original Medicare Plan Part A:
Covering hospitalization......Page 76
Original Medicare Plan Part B:
Covering medical expenses......Page 78
Medigap and Medicare SELECT......Page 80
Medigap......Page 81
Medicare SELECT......Page 82
Medicaid......Page 83
Children's Health Insurance Program ( CHIP)......Page 85
Keeping Good Records......Page 86
Managing Coordination of Benefits (COB)......Page 89
Submitting a Claim......Page 90
Appealing a Claim......Page 94
Recognizing Your Emergency Room Rights......Page 97
Consumer Protection and Confidentiality......Page 99
Protecting your privacy......Page 100
Insurance Fraud......Page 102
Drawing Up Your Selection Criteria......Page 105
Covering yourself, your spouse,
and your dependents......Page 106
Selecting doctors and hospitals......Page 107
Waiting for coverage to start......Page 110
Using Your Health Insurance Checklist......Page 111
CLIFFSNOTES REVIEW......Page 115
Books......Page 119
Other Media......Page 120
Resource Kit......Page 122
Send Us Your Favorite Tips......Page 123
INDEX......Page 124