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疾病发作法:补充医疗保险的成本与效益

Illness-episode approach: costs and benefits of medigap insurance.

作者信息

Sofaer S, Davidson B N

机构信息

School of Public Health, University of California at Los Angeles 90024.

出版信息

Health Care Financ Rev. 1990 Summer;11(4):121-31.

Abstract

Over two-thirds of Medicare beneficiaries have private supplementary coverage, but few know enough about Medicare, their own supplements, or available alternatives to make intelligent comparisons and informed purchasing decisions. The illness-episode approach, a new way to provide insurance information to Medicare beneficiaries, calculates out-of-pocket costs likely to be faced by beneficiaries experiencing 13 illnesses, under Medicare alone and under different medigap policies. Applying the approach to six policies marketed in Los Angeles in 1986 revealed that plans varied widely in their ability to reduce financial vulnerability; many still leave the elderly with substantial out-of-pocket costs.

摘要

超过三分之二的医疗保险受益人拥有私人补充保险,但很少有人对医疗保险、他们自己的补充保险或可用的替代方案有足够了解,从而无法进行明智的比较并做出明智的购买决策。疾病发作方法是一种向医疗保险受益人提供保险信息的新方式,它计算了仅在医疗保险以及不同的补充医疗保险政策下,患有13种疾病的受益人可能面临的自付费用。将该方法应用于1986年在洛杉矶销售的六种保险政策后发现,这些计划在降低经济脆弱性的能力方面差异很大;许多计划仍会让老年人承担大量自付费用。

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