Not Really a Secret Lair

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The Three-Stage Model

When you have health insurance, you have a contract (health plan) with the insurance company that says that for the duration (the plan year) of the contract, you will pay them the agreed upon monthly fee every month (the premium), in exchange for them paying for your health care... some.

How much is "some"? Well, that depends.

To understand what it depends on, you have to understand the three-stage model that health plans are organized around.

This three-stage model is never described as such. It is implicit in the standard terms (jargon) of the health insurance industry, and it is never made explicit. There is no industry term (jargon) for the model itself. There are no terms (jargon) for the three stages. But health insurance becomes vastly easier to understand if you think about it in terms of the three-stage model that is hiding in just about every health plan's terms (agreements).

( Read more: 12,170 (sic!) riveting words about health insurance in the US] )

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