Their freedom is balanced by higher deductibles and maximum out-of-pocket expenses. Began in 1980 as the Schenectady County Foundation for Medical Care, MVP Health insurance has been serving people since then. Within an HMO a policyholder is assigned to a particular doctor or primary care physician (often referred to as a “gatekeeper”) and the policyholder must go through the primary care physician in order to receive treatment. I entered my own zip code for a test, and I was surprised to see that there were several of these clinics within a short drive of my house. PPOs do have some drawbacks, however
OK, now, finally, we’ve reached Medicare! BUT (you really didn’t think it would be that easy, did you?) if you have qualified for Medicare because of disability, there are RESTRICTIONS (of COURSE there are!). But, Congress prescribed that states (all but 11) offer what is called “Medicare supplement” plans, some of which do offer prescription coverages. The comfort and security of knowing you can see a doctor whenever the flu strikes or when you’ve broken your leg on the ski slopes is a privilege that many take for granted. If you have been recently terminated, the law allows you to get a health insurance for yourself (and your family, if you had family coverage while you were employed) at the group rate even though you are not employed anymore
It would be horrific to be denied coverage after paying premiums for so long only because of a question on the form answered dishonestly. You may need to add additional benefits to your insurance to get the proper coverage that you need. And, of course, one must be honest on all the forms
It was in an attempt to reconcile these differences that the concept of managed care was developed. There’s another basic problem with the current system: it’s the assumption that health care is a benefit of employment. For example, your health insurance plan might require you to pay a 30 dollar copay for each primary care doctor office visit, or it might require a 10 dollar co-pay for each generic prescription you fill. Nevertheless, with a knowledge of some of the key terms you can keep your head above the confusion and remain informed on the ins and outs of health insurance coverage
