CHIP stands for Children’s Health Insurance Program and was initiated by the Congress in 1997. It is a special program connecting federal and state government with the aim to provide additional health coverage to uninsured children and future mothers who don’t have the financial abilities to purchase a separate individual policy but still don’t qualify for Medicaid.
On February 4, 2009, CHIP was expanded by President Obama’s passing of law on Children’s Health Insurance Program Reauthorization Act (CHIPRA). This expansion raises the number of children within CHIP from 7 million to 11 million and extends its payment through 2013. Continue reading →
Having an Exclusive Provider Organization (EPO) means that the medical service providers you will receive care from should have signed up an agreement with the insurance company to allow offering you these services. This way EPO plans are somewhat similar to PPO (Preferred Provider Organization) plans, meaning that the person having such a plan can obtain inexpensive medical services at a facility that makes part of the EPO network. Still, if you choose to receive your medical care at a facility outside the network, a PPO plan will still cover your costs, only to a smaller extent. With most EPO plans, you won’t receive any insurance coverage when visiting a specialist outside the network.
When you choose an EPO plan, you will instantly notice that the fees you are charged with by the medical service providers that have accepted to join your insurance company’s network are significantly lower than those normally charged. So when you receive your health benefits within the EPO network, you can rest assured that the rates you will be charged for the services will be very advantageous and your insurance provider will pay for all the services you receive.
However, if you have a condition that none of the specialists making part of the EPO network can help you with and you are forced to seek medical attention outside of the network, make sure you have enough money because you will pay for the service to the full extent. This is because EPO plans do not include any services provided outside the selection of facilities and specialists that have an agreement with the insurance carrier. Moreover, in contrast with PPO and HMO plans that have fairly large networks of health service providers, EPO plans usually have a much smaller number of specialists and facilities being part of their network. This means that you have fewer professionals to choose from when you need medical attention.
In what concerns health service providers, their advantage in joining an EPO network is in the increased number of patients they work with. So instead of charging higher rates to a smaller number of patients, they charge lower rates for a much higher number of people and get more revenue as a result. This is especially useful to those providers who target themselves at a certain geographical area and want to get more people through group health insurance coverage plans. The insurance companies, which choose to provide EPO plans charge their customers with monthly premiums and act as mediators between the customers and the medical service providers. Continue reading →