I just took a new job with a capitated health care plan. What does this mean?
Capitation means that you or your employer pays a set dollar amount to a health maintenance organization (HMO). It doesn't matter how much you use (or don't use) the health services offered.
An HMO is always a "pre-paid" or "capitated" insurance plan. Either the worker or the employers pays the fixed monthly fee for services. There isn't a separate charge for each visit or service. The monthly fees remain the same each month whether or not you see a doctor, nurse, or other health care provider in the plan.
Services are provided by doctors and other providers who are employed by or under contract with the HMO. HMOs vary in design. Depending on the type of the HMO, services may be provided in a central facility or in a physician's own office.
When shopping for a health care plan, consumers must be able to understand the terms and phrases used by insurance agents, companies, and providers. There is a ealth insurance resource center with glossary of terms to explain unknown words or phrases. Check it out at http://www.healthinsurance.org/insterms.html.
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