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Managing Your Health Care

Understanding health care has become harder every year. Many of us get the care we need. Unfortunately, at times we can face uncertainty, frustration, and confusion when problems develop with our health care plans. These problems often come at a time when we are sick and least able to look after ourselves. This brochure provides an overview of some of your legal rights when it comes to your health. It also helps you navigate the system when problems arise. Above all, this brochure will educate you to be an informed and active health care consumer.

This publication contains some words that may need further explanation. You may want to scan the Glossary of Terms before reading ahead.


Table of Contents

The following is a table of contents for the Managing Your Health Care Handbook. You may click on the headers for more information on that topic.

Private Health Care Coverage

  • Relationships Between Patients, Doctors, and Health Plans
  • Individual Coverage
  • Group Coverage
    • Fully-Insured Group Plan
    • Self-Insured Group Coverage
  • A Word about Short-Term Policies

Understanding Your Policy

  • Premiums, Co-Pays, Deductibles, and Annual Maximums
  • Frequently Asked Questions

Tips on Fighting Back

  • How to Get the Health Care You Need

Appeals, Grievances, and Complaints

  • Internal Appeals
  • External Appeals
  • Making a Complaint to a Government Agency
    • Self-Insured Plans
    • Fully-Insured Plans
    • Special Note on ERISA Plans
    • Other Types of Complaints

Prescription Drugs

  • Medicare Part D Prescription Drug Benefit

Medigap and Long-Term Care Insurance

  • Medicare Supplement Policies
  • Long-Term Care Insurance
  • Long-Term Care Partnership Program
  • Nursing Home Care

Medical Billing

  • Charging the Uninsured a Fairer Price and Changing Collection Practices
  • A Note about Collection Practices

Protecting Private Information

  • Federal Law
  • State Law

Questions about COBRA and Continuation Coverage

Government Programs and Assistance

  • Medical Assistance (“MA”)
  • Medical Assistance for Employed Persons with Disabilities (“MA-EPD”)
  • MinnesotaCare
  • Medicare
    • Medicare Supplemental Programs
  • Minnesota Board on Aging
  • Making a Complaint to a Government Agency

Glossary of Terms



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Medical Billing Pointers

Medical billing can be confusing. A clinic may bill you before your insurance has been given a chance to pay, you may have a high-deductible insurance plan and you are struggling to keep up with large hospital bills, or other people may find all the terminology used by their insurance company baffling. In any of these cases, the following medical billing pointers may be of help.

Know Your Hospital Status

When you are admitted to a hospital, it is only natural to believe that you have been admitted as a regular patient, or an "inpatient," to that hospital. Yet, a concept known as "observation status" can affect the amount you pay if you are on Medicare.