ESL Podcast 269 - Health Insurance Plans

HMO - health maintenance organization; an organization of doctors and hospitals that work with a specific insurance company and offer their services for a set price; individuals must always see a doctor within the organization and see their main doctor first, but it is less expensive than using a PPO

Anatole wanted to see a specialist for his stomach pain, but he had to go to his regular doctor first because he's a member of an HMO.

PPO - preferred provider organization; an organization of doctors and hospitals that work with a specific insurance company and offer their services for a set price; individuals can see any doctor, but it is more expensive than an HMO

Mel pays a lot for his PPO, but he likes being able to see any doctor whenever he needs to.

managed health plan - any plan that helps members get health care for a lower cost, especially if there are medical emergencies

If healthcare is important to you and your family, before you accept a new job, ask the employer what kind of managed health plans are available.

co-pay - the amount that a person who has health insurance must pay each time he or she has a medical appointment

Ulysses has a $10 co-pay every time he goes to the dentist.

coverage - the number of different types of medical care that a health insurance plan will help people pay for

This health insurance plan includes coverage for mental health counseling.

network - a group of people who are connected to each other and communicate and share information with each other

Is there a national network of elementary school teachers?

drug coverage - the number of different types of medicines that a health insurance plan will help people pay for

Dion's health insurance plan has horrible drug coverage. He had to pay the full price for all the medicine that he needed last year.

affiliated - officially connected with something else; officially in a business relationship with something else

Don't forget to put on your resume a list of the professional organizations that you're affiliated with.

bureaucracy - a complicated system of rules that a business or government agency follows that make it operate very slowly

Private companies can usually work faster than government agencies because they don't have such large bureaucracies.

to get lost in the shuffle - to not receive the attention that someone or something needs because there are many other people or things in the system

Applying for a work visa is difficult because the applications often get lost in the shuffle, and it can take months to get a response.

primary care physician - the doctor whom one regularly sees; a general doctor who can provide medical care for most common health problems

I have been with my primary care physician for ten years because she's a great doctor.

specialist - a doctor whom one sees only for a specific type of health problem; a doctor who has a lot of training in a specific type of medicine

When Rebecca hurt her back during soccer practice, she had to make an appointment with a back specialist.

to refer - to recommend that someone speak with a specialist about a specific health problem

When the doctor couldn't figure out what was wrong with Conrad's skin, he sent him to a dermatologist who was an expert in skin diseases.

office visit - an appointment with a doctor or dentist where one goes to the medical office and speaks with the doctor or dentist in person

The doctor would not prescribe something for my headache unless I made an office visit so he could examine me.

opening - an available appointment; a time when a doctor is available to meet with a patient; an open period of time on a doctor's calendar

Dr. Brenson has openings at 3:00 and 4:45 that day. Which would you prefer?

grievance - a complaint about something that isn't fair or that is against the rules

Adel filed a grievance against her employer because she says that the company pays women less than it pays men.

right - something that one should be able to have or do because it is good, true, or fair; a privilege given to a person or a group of people

Do people under the age of 18 have the right to vote in this country?

resolution - a solution or end to a problem or argument

The two countries are going to war because they can't find a resolution to their problems.

blind - unable to see anything because one's eyes don't work properly

Alina was born blind, so she has always used a dog to "see" for her while she's walking outside.