| One of the most widely publicized and hotly | | | | protect or correct eye health are usually |
| debated forms of insurance in America today, | | | | covered. At this time LASIK or other |
| health insurance is the subject of intense | | | | corrective procedures are rarely covered. |
| political and social debate. A rapidly | | | | |
| evolving and extremely complex subject, | | | | Managed Care |
| health insurance is also one of the most | | | | |
| important benefits offered by many employers. | | | | One of the biggest trends in medical |
| | | | insurance over the past two decades in the |
| Types of Insurance | | | | United States has been the rise of managed |
| | | | care as a primary delivery model for medical |
| Medical Insurance typically covers and | | | | care. Based on the concept of centralized |
| specifies payment levels for doctor visits | | | | decision making, pooled resources, and |
| and treatment, medications, hospital stays, | | | | efficient delivery of services, Health |
| emergency room visits, surgical treatment, | | | | Management Organizations, or HMOs, do offer |
| and so forth. There are wide variations in | | | | economical coverage, often at much lower |
| coverage plans, with numerous combinations of | | | | premiums than privately managed insurance |
| covered and excluded items, different | | | | plans. Critics, however, point to longer wait |
| coverage levels, deductible amounts, and | | | | times for appointments, fewer physicians from |
| other variables that make it impossible to | | | | which to choose, and often the need for |
| offer a general statement regarding all | | | | specialist referrals as weaknesses of the HMO |
| coverage plans. | | | | mode. |
| | | | |
| Many employers offer an open enrollment | | | | Regardless of the advantages or disadvantages |
| period annually, during which employees may | | | | of HMOs, it seems certain that this |
| select from different coverage plans. Careful | | | | organizational model will continue to grow in |
| selection of the appropriate plan for each | | | | popularity. |
| individual is a critical task. | | | | |
| | | | Medicare and Medicaid |
| Dental Insurance is sometimes included in | | | | |
| medical plans, but more often it is a | | | | The United States government has, for many |
| separate policy. Virtually all dental plans | | | | years, funded two particular programs to help |
| cover annual or semi-annual cleanings and | | | | extend medical coverage to individuals who |
| check-ups, with many plans increasing the | | | | may not be able to otherwise access the |
| covered percentage with regular appointment | | | | necessary health care. Medicare is designed |
| attendance over time. Routine treatments such | | | | to help elderly Americans pay for their |
| as cavity fillings, bridges, and the like, | | | | health care. |
| are also typically covered, though the amount | | | | |
| of coverage can vary. Braces are sometimes | | | | More recently, the Medicare Part D program |
| covered for minor dependents, and more rarely | | | | was set up to help the elderly pay for |
| for adults. Cosmetic procedures are typically | | | | prescription drugs. Medicaid is intended to |
| not covered. | | | | help impoverished Americans obtain health |
| | | | care; however, with high administrative |
| Vision insurance is often offered as a | | | | costs, low reimbursement rates, and an often |
| separate plan to go along with medical | | | | complicated set of restrictions and |
| insurance. Vision plans typically cover an | | | | requirements, the number of physicians who |
| annual check-up, with glasses or contacts | | | | accept Medicaid has decreased steadily over |
| covered to a pre-determined limit every year | | | | the past several years. |
| or two. Necessary medical procedures to | | | | |