(Re)Insured?: Health - Choosing and Changing Plans

Changes and Choices

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?

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.

This FAQ can help you make sense of your choices for getting health care insurance:

Choosing a Plan: 1. What Are My Health Plan Choices?; 2. Where Do I Get These Health Plans?; 3. What Plan Benefits Are Offered?
4. What Is Most Important to Me in a Plan?; 5. How Do I Compare Health Plans?; 6. How Do I Find Out About Quality?

Using Care: 7. How Can I Get the Most from My Plan?
8. How Do I Obtain Care?
9. What if I Have to Go to the Hospital?; 10. What if I Am Not Satisfied with My Care?

Primary Care Doctors
Pre-Existing Conditions
Tips on Choosing a Doctor

This consumer's guide was developed by the Agency for Health Care Policy and Research, U.S. Department of Health and Human Services, Rockville, MD, in cooperation with the Health Insurance Association of America, Washington, DC.