April 2000 Issue

We will be bringing you some of the best articles and links on health and other issues that we can find and hope you will enjoy them enough to share our magazine with your friends and family.

Please make note at the top of our page are some Very Helpful Links to sites that will make your page building experiemce an enjoyable one.

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At the bottom of our page, you will find a list of everyone who make up the HotSprings Community Leaders group. We would like to invite you to visit our sites and email us if you need help or just to say "hello" We are always happy to hear from you.

Health Insurance as we all know can be very hard to get for some and Very confusing for everyone. In this issue we hope to help clearify some things for you and help direct those in need of Insurance to some helpful resources.

PPO, HMO, Medicare, Medicare Complete, Medicade, What DO all of these mean???

We will give you our most simplest terms and explanations of each of these. We hope to help you understand in general how each of them work and what you can expect from each policy.Disclaimer

PPO (Preferred Provider Orginization)

The PPO plan is offered by many Companies. It allows you (the patient) to choos from a large selection of health care providers. Large enough that you will almost never have to go outside of the program for health care. If need be, The PPO program allows you to see health care providers "outside" of their program plan and still cover part of the fees.

Most PPO plans have no deductable (money YOU have to pay before the policy kicks in) This is a plus if you use your insurance frequently. PPO plans, like others, have Co-Pays for Office Visits, and Prescriptions, these can vary from $5.00-$15.00 depending on your policy and your choices of health care providers. While a doctor IN the program would be a $10.00 Co-Pay seeing a specialist might be $15.00.

While a supplemental Insurance (insurance to cover cost NOT covered by your primary Insurance) is not usually nessesary with a PPO program, you might choose to have one, for times that you go outside the plan.

HMO (Health Maintenance Orginization)

The HMO plan is also a very popular plan offered by many companies, however it is more limiting as to your choice of health care providers. Ths plan has a set list of healthcare providers that you must go to in order for the insurance to cover the services. While the list of proiders is large, if you want to choose ANY doctor you want the HMO plan would not be for you. Again, there are a great deal of providers in the HMO plans.

The HMO plans usually do not have a deductale however if you choose a plan with lower monthly premium, a deductable is added to the plan. If you wont be carrying a supplemenal insurance, and you know you will be using your policy frquently, you might consider paying the higher monthly premium and avoid the deductable.

HMO plans also have Co-Payments for Office Visits and Prescriptions again ranging from $5.00-$15.00 Again, Supplemental Insurance would not be nessesary if you plan to stay WITHIN the program and ot use providers not on their list.

Medicare

Medicare has long been the Insurance to "take Care" of our elderly, however in recent years I have seen it dwindle down to almost nothing making it nessesary for a supplemental insurance meaning even more money out of the pockets of those who really cant afford it.

Medicare has a deductable of over $700.00 per year for in hospital care, after that has been met the policy covers 80%. Many senior citizens live only on their social security making it possible to meet this deductable if hospitalized.

While there are no Co-Payments, Office Visits are usually covered at 80%. The patient must pay in full upfront and get reimbersed by medicare for their 20%. Prescriptions are not covered by Medicare.

The Mediare Plan does allow you to see ANY health care provider. The cost of Medicare per month is about $45.00 and comes out of your socal security check. Medicare is also offered to those UNDER 65 years of age if they have been disable for a period of 2 years. The policy is the same.

Medicare Complete

Medicare Complete is an HMO plan offered by Medicare. It allows Senior Citizens and disabled people to choose an HMO plan like shown above.

While there has been no deductable in the past, this year there has been a $50.00 per day Co-Pay UP TO $350.00 per year for hospitalization.

This plan has Co-Payments for Office Visits and Prescriptions like the HMO plan above. However this year, they have remove the "preferred List" of medications limiting the Co-Pays to generic medications. While generic medications are fine if you are in need of a name brand medication you will have to pay full price.

The cost for Medicare Complete is the same as for Medicare around $45.00 and also comes out of your social security check.

Medicade

Medicade is a State Funded program for low income families. It allows families with low income (this amount will vary from state to state) to provide health insurance for their children. All Office Visits and Prescriptions are covered IN FULL while on Medicade.

Medicade can also be received by those who are not able to work and cannot afford health insurance on their own. You can contact your local Welfare Office for help and information on how to receive Medicade.

We Are Your HotSprings Community Leaders!

Liaison

Doc

Co-Liaisons

MaryLee Tigerlily Rebel

Community Leaders

Cindy	Duggan	Frank	Gabriel	HealerGuide
Hopemcg	Mary Lou	Oldlace	Shannon	Teresa

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