A community of 30,000 US Transcriptionist serving Medical Transcription Industry
I've been doing a lot of research in the past few weeks and wonder if others have reached the same conclusions.
My MTSO is offering a backup "mini-medical" (reduced benefits) plan for employees whose hours have been decreased due to lack of work. When I resarched this kind of plan, this is what I learned.
1. A typical major medical insurance plan: Your insurance carrier recommends seeing in-network care providers. The carrier has pre-negotiated rates with these providers. Example: A hospital charges $20,000 for an appendectomy. The insurance carrier has negotiated with its preferred providers an agreed-upon fee for this procedure of $3000. The hospital accepts that reimbursement, and the carrier and facility agree that you (the patient) are not responsible for anything further (assuming that the deductible and co-pays have been satisfied).
2. An indeminty medical insurance plan: You can see whomever you wish for medical care. A hospital charges $20,000 for an appendectomy. The insurance carrier pays what it determines to be a standard and usual charge for the procedure; say, $3000. The hospital then bills you for the remaining $17,000. ...OR you go to your PCP. His/her tyipcal charge for an OV is, for example, $150. Your indemity carrier thinks that a reasonable charge is $40, which they pay. You then owe the balance of $110. I believe this kind of policy is called "bill back" coverage, meaning that the facility will bill back the patient for any charges not covered by the carrier in order to recover its original (inflated) charges. You, the patient, don't have any protection afforded by negotiation.
3. A mini-medical insurance plan: Same as indemnity?? There may be different kinds of mini-medical policies, but the description above (#2) seems to be what the majority are offering. Frankly, I don't see the purpose of offering it or paying for it at all, and the rates are unreasonable. If I'm overlooking something, would somebody point it out to me?
...confused and disappointed.