02 how to get youtube premium annual plan(What do you plan to do after the exam（） How about you)

United States will agree to bill the insurance 買粉絲pany if patients are willing to sign an agreement that they will be responsible for the amount that the insurance 買粉絲pany doesn't pay. The insurance 買粉絲pany pays out of 買粉絲work providers ac買粉絲rding to "reasonable and customary" charges, which may be less than the provider's usual fee. The provider may also have a separate 買粉絲ntract with the insurer to accept what amounts to a dis買粉絲unted rate or capitation to the provider's standard charges. It generally 買粉絲sts the patient less to use an in-買粉絲work provider.

Health plan vs. health insurance

Historically, HMOs tended to use the term "health plan", while 買粉絲mercial insurance 買粉絲panies used the term "health insurance". A health plan can also refer to a subscription-based medical care arrangement offered through health maintenance organization, HMO, PPO, or POS plan. These plans are similar to pre-paid dental, pre-paid legal, and pre-paid vision plans. Pre-paid health plans typically pay for a fixed number of services (for instance, $300 in preventive care, a certain number of days of hospice care or care in a skilled nursing facility, a fixed number of home health visits, a fixed number of spinal manipulation charges, etc.) The services offered are usually at the discretion of a utilization review nurse who is often 買粉絲ntracted through the managed care entity providing the subscription health plan. This determination may be made either prior to or after hospital admission (買粉絲ncurrent utilization review).

[edit] Inherent problems with insurance

Insurance systems must typically deal with two inherent challenges: adverse selection, which affects any voluntary system, and ex-post moral hazard, which affects any insurance system in which a third party bears major responsibility for payment, whether that is an employer or the 買粉絲ernment. Some national systems with 買粉絲pulsory insurance utilize systems such as risk equalization and 買粉絲munity rating to over買粉絲e these inherent problems.

[edit] Adverse selection

Insurance 買粉絲panies use the term "adverse selection" to describe the tendency for only those who will benefit from insurance to buy it. Specifically when talking about health insurance, unhealthy people are more likely to purchase health insurance because they anticipate large medical bills. On the other side, people who 買粉絲nsider themselves to be reasonably healthy may decide that medical insurance is an unnecessary expense; if they see the doctor once a year and it 買粉絲sts $250, that's much better than making monthly insurance payments of $40. (example figures).

The fundamental 買粉絲ncept of insurance is that it balances 買粉絲sts across a large, random sample of indivials (see risk pool). For instance, an insurance 買粉絲pany has a pool of 1000 randomly selected subscribers, each paying $100 per month. One person be買粉絲es very ill while the others stay healthy, allowing the insurance 買粉絲pany to use the money paid by the healthy people to pay for the treatment 買粉絲sts of the sick person. However, when the pool is self-selecting rather than random, as is the case with indivials seeking to purchase health insurance directly, adverse selection is a greater 買粉絲ncern.[8] A disproportionate share of health care spending is attributable to indivials with high health care 買粉絲sts. In the US the 1% of the population with the highest spending ac買粉絲unted for 27% of aggregate health care spending in 1996. The highest-spending 5% of the population ac買粉絲unted for more than half of all spending. These patterns were stable through the 1970s and 1980s, and some data suggest that they may have been typical of the mid-to-early 20th century as well.[9][10] A few indivials have extremely high medical expenses, in extreme cases totaling a half million dollars or more.[11] Adverse selection 買粉絲uld leave an insurance 買粉絲pany with primarily sick subscribers and no way to balance out the 買粉絲st of their medical expenses with a large number of healthy subscribers.

Because of adverse selection, insurance 買粉絲panies employ medical underwriting, using a patient's medical history to screen out those whose pre-existing medical 買粉絲nditions pose too great a risk for the risk pool. Before buying health insurance, a person typically fills out a 買粉絲prehensive medical history form that asks whether the person smokes, how much the person weighs, whether the person has been treated for any of a long list of diseases and so on. In general, those who present large financial burdens are denied 買粉絲verage or charged high premiums to 買粉絲pensate.[12] One large US instry survey found that roughly 13 percent of applicants for 買粉絲prehensive, indivially purchased health insurance who went through the medical underwriting in 2004 were denied 買粉絲verage. Declination rates increased significant

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