The benefits offered for hospitalization have changed recently, as health plans experiment with ways to encourage consumers to choose less costly hospitals. Some health plans in California have developed products that put hospitals into groups (or “tiers”) based on costs. The plans require that consumers pay more for services from higher-cost hospitals.
For example, in a typical two-tier HMO product, a consumer might pay nothing out-of-pocket for a stay in a lower-cost hospital, but be subject to a $100 to $400 charge if hospitalized at a higher-cost facility. Some health plans offer hospital tiering as an optional benefit; others have made it a mandatory feature of all small group products.
- Alternatives to Offering Group Coverage
- Group Coverage
- Health Maintenance Organizations (HMOs)
- Health Savings Accounts (HSAs)
- Individual Coverage
- Plan Characteristics and Types
- Point-of-Service Plan (POS)
- Preferred Provider Organizations (PPOs)
- Public or Subsidized Health Insurance
- Tiered Hospital Benefits
- Health Reimbursement Arrangements
- Plans Offered Under the Health Insurance Exchanges