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A comprehensive guide designed to help consumers understand the American health insurance system so that they can obtain the benefits to which they are entitled. Epstein explains the ins and outs of both new and traditional health insurance plans, including traditional individual and group policies, HMOs and other types of managed care plans, self-funded plans, Medicare, Medicare HMOs, Medigap, long-term care, COBRA, CHAMPUS, and Medical Savings Accounts.
Written by a nationally syndicated columnist, this useful volume also deals with special health insurance issues related to children, adults with special needs, and individuals who may need long-term care. In addition, Epstein provides valuable information for individuals who are in the process of changing jobs or making changes in their marital or family status, choosing a health insurance plan, or arranging long-term care-including placement in a nursing home or an assisted-living facility-for an aging parent. The book has a practical focus with a variety of tables and worksheets to help consumers establish a system for preventing health insurance problems, and for dealing with any health insurance problems that may arise. It also contains answers to common questions about health insurance, and provides a list of organizations that offer detailed information and advice in regard to specific health insurance problems.
List of contents
Introduction
The Basic ToolsThe Health Insurance Maze
Understanding the Language of Health Insurance
Developing a Systematic Approach to Dealing with Health Insurance Claims
Health Insurance PlansTraditional Individual and Group Plans, Doctors' Bills
Traditional Individual and Group Plans, Hospital Bills
Self-funded Plans
Managed Care Plans
CHAMPUS and Medical Savings Accounts
Medicare and Medicare-Related ProgramsMedicare
Medigap and Secondary Health Insurance Policies
Medicare HMOs
Specialized SituationsExtending Coverage through COBRA, the Portability Act, and Conversion Options
Programs for Children and Adults with Disabilities and Special Health Care Needs
Coverage for Long-term Health Care
Conclusion: The Future of Health Insurance in America
Appendix A: Ten Frequently Asked Questions about Health Insurance
Appendix B: Sources of Information and Advice on Specific Health Insurance Issues
Glossary
Index
About the author
RICHARD EPSTEIN writes a nationally syndicated newspaper column, Insurance TroubleShooter, as well as a health insurance column for
Exceptional Parent Magazine. With a BA degree from Brooklyn College, a masters from the New School for Social Research, and additional post-graduate work at the New School and at Columbia University, Epstein began researching the health insurance maze 15 years ago, when his spinal arthritis became so severe that he required an electric wheelchair for mobility. He found that many of the rules that insurance companies followed seemed illogical and, at times, almost incomprehensible.
