I have health care in the U.S. through my job, and I don't understand some fundamental things about how it works. So I'd like to ask two questions:

-- Where can I find a basic FAQ about what I should know as a patient.

-- My other question is this: When I go to the doctors office, am I expected to stop him every time he does anything to me to see what it will cost me? A few months ago I went to my doctor with a chronic cough. Obviously, I wanted the diagnosis and possible treatment. So he asked questions, ran a few tests (chest x-ray, flow loops), and sent me on my way. Now I owe $121. Was I supposed to, before each test, ask Doc to head over to the billing dept to see what each thing was going to cost me? I just don't understand how the whole thing fundamentally works. I mean, I'm not poor but I'm no moneybags, and I can hardly be expected to walk into the office and not know how much they're going to charge me! What if I can't afford it?

Your doctor should have given you a privacy notice at your first appointment (or around then)--that covers HIPAA regulations. Other information can be found online, usually under the headings of "patient rights." Different clinics and hospitals and states may have their own versions, but basically, you have certain rights--like to do not be discriminated against, to be able to refuse treatment, etc.

And you should be allowed to ask about the cost. Different insurance plans work different ways, and the best source is the plan booklet (or website). That will outline what's covered and what's not. Of course, it's doubtful that you'll have that memorized when you go in to see a doctor, as far as whether an x-ray is covered, etc. But you can ask the cost or whether it's covered. Doctors often aren't thinking about that stuff when they decide to do the test.

Please note that this thread is moved to the Health Insurance Issues Board.

You should ask your employer for a detailed policy and Summary Plan Description for the exact policy under which you are covered. Many employers offer a variety of plans from HMO, to PPO, to POS, to indemnity all with different levels of co-pays, co-insurance, and out of pocket maximums.

The way the plan I have works is I am responsible for the first $1500 in any year. After that I must pay 20% of fees up to a max of $1000. So my total out of pocket max in any one year is $2500.