Similar to Medicare but also includes a pharmacy benefit and nursing home care

Pays a base amount to Independent Option providers, and you pay the gap between the base payment and the providers' charges.

Advantages

• First visit/year has no copay
• Small copay for most visits
• Medication costs limited to an affordable gap payment
• No charges for patients with low incomes or expensive catastrophic illnesses
• Choice of quality providers because financial incentives assure that providers will choose to serve Copay Option patients 60% of the time.

Advantages

• Greater choice of providers
• Providers may offer increased benefits, such as immediate appointments, longer visits.
• Gap payments are affordable because financial incentives keep gap payments low so that patients will choose to see an Independent provider nearly half the time.

Additional Advantages for Consumers

• Real health care security:
You are always covered by both options regardless of employment.

• Emergency room care: Always available on the low-cost Copay Option.

• Gap payments lower the total cost of health care: Pharmaceutical companies and providers will lower their prices to compete for customers who want a smaller gap payment.

• Balanced Choice costs less than people already spend on health care: Because Balanced Choice lowers costs and makes the health insurance industry obsolete and unnecessary, it saves enough money to more than pay for the added benefits.

Advantages for Providers

• Choice of which Option to use when accepting each new patient
• Ability to transfer patients from one Option to another with adequate notice
• Freedom to raise rates for Independent Option patients
• Assurance that treatment for all patients is covered
• Relief from administrative complexity and bookkeeping of multiple types of insurance
• Great reduction in managed care
• Assurance that both Options reimburse an appropriate amount, based on the market, not the government
• Prompt reliable payment and reduced write-off costs

Advantages for Employers

• Improves employers' ability to compete in the global marketplace because there is no longer a responsibility to provide health care
• Lowers the overall amount employers contribute to health care costs
• Eliminates employers' responsibility for workers' compensation or auto accident related health care costs
• Protects employers from future increases in health care costs