Siderea (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
siderea) wrote2025-12-14 08:45 am
siderea) wrote2025-12-14 08:45 am
Entry tags:
Understanding Health Insurance: The Three-Stage Model [healthcare, US, Patreon]
Canonical link: https://siderea.dreamwidth.org/1891517.html
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] )
This post brought to you by the 221 readers who funded my writing it – thank you all so much! You can see who they are at my Patreon page. If you're not one of them, and would be willing to chip in so I can write more things like this, please do so there.
Please leave comments on the Comment Catcher comment, instead of the main body of the post – unless you are commenting to get a copy of the post sent to you in email through the notification system, then go ahead and comment on it directly. Thanks!
This is part of Understanding Health Insurance
- Introduction
- A Health Plan is a Contract
- The Three-Stage Model ⇐ You are here
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] )
This post brought to you by the 221 readers who funded my writing it – thank you all so much! You can see who they are at my Patreon page. If you're not one of them, and would be willing to chip in so I can write more things like this, please do so there.
Please leave comments on the Comment Catcher comment, instead of the main body of the post – unless you are commenting to get a copy of the post sent to you in email through the notification system, then go ahead and comment on it directly. Thanks!
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