1. Health Care Objective:
To illustrate the difference among different health insurance policies.

2. PPO: Preferred Provider Organization
Need to get your care from doctors who are on the insurances, “Preferred Provider List,” if you want them to pay for most of it.
Not required to go through your primary doctor for all visits.
Typically more expensive.

3. HMO: Health Maintenance Organization
Group insurance that entitles members to use services at participating hospitals.
Traditionally: lower monthly payments and co-pay.
Doctors serve as gate-keepers to care.

4. Monthly Premium
Monthly payment for insurance plan.

5. Deductible
A specific dollar amount that your health insurance company may require that you pay out-of-pocket each year before your health insurance plan begins to make payments for claims.
Not all health insurance plans require a deductible.
As a general rule (though there are many exceptions), HMO plans typically do not require a deductible, while most PPO plans do.

6. Office Visit (Co-Pay)
An office Co-Pay is a monetary amount you pay ($$) when you see the doctor, or dentist for routine care.

7. Coinsurance
The amount that you are obligated to pay for covered medical services after you’ve satisfied any co-payment or deductible required by your health insurance plan.

8. Health Care Activity 89
Utilize the following for average cost of health care in California.
Government Health Care and
Free Clinics - $1, (or about $ per month)
HMO - $13, /12 = $ per month
PPO - $13, /12 = $ per month
Divide the sample annual costs from page 94 by 12 and put that dollar amount on the, “Health Care” line [9].
Place that figure on Activity 92 on line [9].

9. Average Cost