In the Spotlight

News & Features

By Betsy Cole
Minnesota Public Radio
October 2001

The Problem | The Fix | The Alternatives
Are you or aren't you? According to the Employee Benefit Research Institute, most insured Americans don't know whether they're enrolled in a managed care plan - but a 2001 Health Care Confidence Survey says about 90 percent of workers taking part in a health plan are in managed care. Read more about managed care confusion.
There's considerable confusion among consumers about the available forms of health care coverage and the effect of proposed reforms on existing plans. Citizens for Patients Rights offers brief descriptions of HMOs, PPOs, Medicare, Medicaid and other plans delivering health care coverage to Americans.
Managed care "report cards" are often provided by employers, consumer groups, hospital associations or health plans themselves. Evaluating the reliability of these reports and making sense of competing plans can be tricky. This fact sheet from the National Health Law Program helps consumers understand health plan report cards and make informed decisions about choosing the appropriate plan.
As public policy makers wrestle with the rising cost of health care and health coverage, many alternatives to traditional managed care systems have emerged. One such alternative - Defined Care, or the so-called "cafeteria-style" plan - is attracting a lot of attention from consumers, employers and politicians alike. This report was produced by Managed Care On-Line, a health care Internet company delivering business-to-business managed care resources.
The Health Insurance Portability and Accountability Act (HIPAA), signed into law on August 21, 1996, offers new protections for millions of American workers that improve portability and continuity of health insurance coverage.
Throughout a career, workers will face multiple life events, job changes or even job losses. Consolidated Omnibus Budget Reconciliation Act, a law enacted in 1986, helps workers and their families keep their group health coverage during times of voluntary or involuntary job loss, reduction in the hours worked, transition between jobs and in certain other cases.
The Employee Retirement Income Security Act (ERISA) governs approximately 2.5 million health benefit plans sponsored by private sector employers nationwide. These plans provide a wide range of medical, surgical, hospital and other health care benefits to some 131 million Americans.
Roughly 500,000 Minnesotans receive health care through the state's three publicly funded health care programs - Medical Assistance (MA - Minnesota's Medicaid program), General Assistance Medical Care (GAMC) and MinnesotaCare. The Minnesota Department of Human Services (DHS) administers MinnesotaCare and oversees MA and GAMC, administered by counties. Through these programs, the state pays all or part of enrollees' medical bills. This brochure provides a brief description of Minnesota's health care programs. Each program has guidelines you must meet to get coverage.