THE INSURANCE INDUSTRY HAS CREATED SEVERAL KINDS OF HEALTH-RELATED INSURANCE COVERAGE. EACH OF THESE KINDS OF HEALTH INSURANCE PROVIDES FOR A DIFFERENT KIND OF COVERAGE. ONE TYPE OF HEALTH INSURANCE IS MEDICAL INSURANCE WHICH CAN BE CATEGORIZED AS (1) HOSPITAL, (2) SURGICAL, (3) REGULAR MEDICAL, (4) MAJOR MEDICAL INSURANCE, AND (5) COMPREHENSIVE MEDICAL POLICY. INSURANCE COMPANIES ALSO MAKE A COMBINATION POLICY AVAILABLE.

WHEN AN ILLNESS OR INJURY REQUIRES YOU TO BE HOSPITALIZED, HOSPITAL INSURANCE USUALLY PAYS MOST OR ALL OF THE CHARGES FOR YOUR ROOM, FOOD, AND EXPENSES FOR SUCH ITEMS AS USE OF AN OPERATING ROOM, ANESTHESIA, X RAYS, LABORATORY TESTS, AND MEDICINES. BECAUSE OF THE HIGH COST OF HOSPITALIZATION, MORE PEOPLE PURCHASE HOSPITAL INSURANCE THAN ANY OTHER KIND OF HEALTH INSURANCE. IN FACT, ALMOST 200 MILLION Americans ARE COVERED BY HOSPITAL INSURANCE.

HOSPITAL INSURANCE CAN BE PURCHASED FROM INSURANCE COMPANIES OR FROM NONPROFIT CORPORATIONS. THE BEST KNOWN NONPROFIT ORGANIZATION THAT OFFERS HOSPITAL INSURANCE IS BLUE CROSS. BLUE CROSS PLANS USUALLY PAY HOSPITALS DIRECTLY FOR CARE PROVIDED TO THEIR POLICYHOLDERS. IF EXPENSES GO BEYOND THE AMOUNT COVERED BY THE BLUE CROSS CONTRACT, THE PATIENT MUST PAY THE DIFFERENCE.

SURGERY IS ONE OF THE MAJOR REASONS FOR HOSPITALIZATION AND IS NORMALLY VERY EXPENSIVE. SURGICAL INSURANCE COVERS ALL OR PART OF THE SURGEON’S FEES FOR AN OPERATION. THE TYPICAL SURGICAL POLICY LISTS THE TYPES OF OPERATIONS THAT IT COVERS AND THE AMOUNT ALLOWED FOR EACH. SOME POLICIES ALLOW LARGER AMOUNTS FOR OPERATIONS THAN OTHERS. THIS, OF COURSE, REQUIRES THAT A HIGHER PREMIUM BE PAID. SURGICAL INSURANCE IS FREQUENTLY BOUGHT IN COMBINATION WITH HOSPITAL INSURANCE.

SURGICAL INSURANCE CAN BE PURCHASED FROM INSURANCE COMPANIES OR FROM NONPROFIT ORGANIZATIONS SUCH AS BLUE SHIELD. BLUE SHIELD IS LINKED WITH BLUE CROSS; THEY ARE OFTEN CALLED "THE BLUES." BLUE SHIELD PLANS COVER MAINLY MEDICAL AND SURGICAL TREATMENT RATHER THAN HOSPITAL CARE. MOST BLUE SHIELD PLANS LIST THE MAXIMUM AMOUNTS THAT WILL BE PAID FOR DIFFERENT TYPES OF SURGERY. THEY ALSO COVER THE DOCTOR’S CHARGES FOR CARE IN THE HOSPITAL AND SOME PLANS PAY THE DOCTOR’S CHARGES FOR OFFICE OR HOME CARE. BLUE PLANS ARE DESIGNED TO MINIMIZE POLICYHOLDERS’ EXPENSES. THEY GENERALLY DO NOT PROVIDE COVERAGE FOR PREEXISTING CONDITIONS OR ILLNESSES OR INJURIES THAT ARE COVERED BY OTHER INSURANCE.

SOMETIMES NORMAL CARE PROVIDED BY A PHYSICIAN CAN BE QUITE EXPENSIVE. REGULAR MEDICAL INSURANCE PAYS PART OR ALL OF THE FEES FOR NONSURGICAL CARE GIVEN IN THE DOCTOR’S OFFICE, THE PATIENT’S HOME, OR A HOSPITAL. THE POLICY STATES THE AMOUNT PAYABLE FOR EACH VISIT OR CALL AND THE MAXIMUM NUMBER OF VISITS COVERED. SOME PLANS ALSO PROVIDE PAYMENTS FOR DIAGNOSTIC AND LABORATORY EXPENSES. REGULAR MEDICAL INSURANCE IS USUALLY COMBINED WITH HOSPITAL AND SURGICAL INSURANCE. THE PROTECTION PROVIDED BY REGULAR MEDICAL, HOSPITAL, AND SURGICAL COVERAGES IS REFERRED TO AS BASIC HEALTH COVERAGE.

LONG ILLNESSES AND SERIOUS INJURIES CAN BE VERY EXPENSIVE. BILLS OF $50,000 TO $100,000 AND HIGHER ARE NOT UNUSUAL. MAJOR MEDICAL INSURANCE PROVIDES PROTECTION AGAINST THE HIGH COSTS OF SERIOUS ILLNESSES OR INJURIES. IT COMPLIMENTS THE OTHER FORMS OF MEDICAL INSURANCE. MAJOR MEDICAL INSURANCE HELPS PAY FOR MOST KINDS OF HEALTH CARE PRESCRIBED BY A DOCTOR. IT COVERS THE COST OF TREATMENT IN AND OUT OF THE HOSPITAL, SPECIAL NURSING CARE, X-RAYS, PSYCHIATRIC CARE, MEDICINE, AND MANY OTHER HEALTH CARE NEEDS. MAXIMUM BENEFITS RANGE UP TO $250,000 AND HIGHER.

ALL MAJOR MEDICAL POLICIES HAVE A DEDUCTIBLE CLAUSE SIMILAR TO THE ONE FOUND IN AUTOMOBILE COLLISION INSURANCE. WITH THIS CLAUSE, THE POLICYHOLDER AGREES TO PAY THE FIRST PART, PERHAPS $500 OR MORE, OF THE EXPENSE RESULTING FROM SICKNESS OR INJURY. MAJOR MEDICAL POLICIES ALSO USUALLY CONTAIN A COINSURANCE CLAUSE. A COINSURANCE CLAUSE MEANS THAT THE POLICYHOLDER WILL BE EXPECTED TO PAY A CERTAIN PERCENTAGE, GENERALLY 20 OR 25 PERCENT, OF THE COSTS OVER AND ABOVE THE DEDUCTIBLE AMOUNT.

THE DEDUCTIBLE CLAUSE DISCOURAGES THE FILING OF MINOR CLAIMS. THE COINSURANCE CLAUSE ENCOURAGES THE POLICYHOLDER TO KEEP MEDICAL EXPENSES AS REASONABLE AS POSSIBLE. THUS, BOTH CLAUSES HELP TO MAKE LOWER PREMIUMS POSSIBLE BECAUSE THEY HELP TO REDUCE PAYMENTS OF INSURANCE CLAIMS.

INSURANCE PROVIDERS HAVE DEVELOPED A COMPREHENSIVE MEDICAL POLICY THAT COMBINES THE FEATURES OF HOSPITAL, SURGICAL, REGULAR, AND MAJOR MEDICAL INSURANCE. A COMPREHENSIVE MEDICAL POLICY RETAINS THE FEATURES OF EACH OF THE SEPARATE COVERAGES SUCH AS AMOUNTS PAYABLE LIMITS AND THE LIKE. IT HAS ONLY ONE DEDUCTIBLE. A COMBINATION OF COVERAGES IS NORMALLY LESS EXPENSIVE THAN THE TOTAL OF THE SEPARATE COVERAGES.

AS DENTAL EXPENSES HAVE GROWN OVER THE YEARS, THE PUBLIC HAS ENCOURAGED INSURERS TO DEVELOP POLICIES TO HELP DEFRAY THE COST OF DENTAL CARE. AS A RESULT, INSURANCE COMPANIES NOW OFFER DENTAL INSURANCE WHICH HELPS PAY FOR NORMAL DENTAL CARE, OFTEN INCLUDING EXAMINATIONS, X-RAYS, CLEANING, FILLINGS, AND MORE COMPLICATED TYPES OF DENTAL WORK. IT ALSO COVERS DENTAL INJURIES RESULTING FROM ACCIDENTS. SOME DENTAL PLANS CONTAIN DEDUCTIBLE AND COINSURANCE PROVISIONS, WHILE OTHERS PAY FOR ALL CLAIMS. DENTAL INSURANCE IS OFFERED MAINLY THROUGH GROUP PLANS AND IS STILL GROWING IN POPULARITY. DENTAL INSURANCE IS GROWING IN POPULARITY WITH ANNUAL CLAIMS EXCEEDING $25 BILLION AND NOW ACCOUNTING FOR MORE THAN HALF OF ALL EXPENDITURES FOR DENTAL SERVICES.

IN ANTICIPATION OF EYE CARE EXPENSES, MANY CONSUMERS AND GROUPS PURCHASE VISION CARE INSURANCE. VISION CARE INSURANCE COVERS EYE EXAMINATIONS, PRESCRIPTION LENSES, FRAMES, AND CONTACT LENSES. HOWEVER, VISION INSURANCE USUALLY DOES NOT COVER SUCH THINGS AS TINTED LENSES, COATED OR PLASTIC LENSES, NONPRESCRIPTION LENSES, AND VISION TRAINING. THE POPULARITY OF VISION CARE INSURANCE RESULTS FROM THE RECOGNITION BY MANY INDIVIDUALS AND EMPLOYERS WHO HELP PAY FOR GROUP PLANS THAT EYE CARE HEALTH IS VERY IMPORTANT.

FOR MOST PEOPLE, INCOME FROM EMPLOYMENT IS THEIR SINGLE MOST IMPORTANT ECONOMIC RESOURCE. PROTECTING YOUR INCOME IS VERY IMPORTANT. THERE IS ONE FORM OF HEALTH INSURANCE THAT PROVIDES PERIODIC PAYMENTS IF THE POLICYHOLDER BECOMES DISABLED. DISABILITY INCOME INSURANCE PROTECTS YOU AGAINST THE LOSS OF INCOME CAUSED BY A LONG ILLNESS OR AN ACCIDENT. THE INSURED RECEIVES WEEKLY OR MONTHLY PAYMENTS UNTIL THAT PERSON IS ABLE TO RETURN TO WORK. DISABILITY INCOME POLICIES FREQUENTLY INCLUDE A WAITING PERIOD PROVISION WHICH REQUIRES THAT THE POLICYHOLDER WAIT A SPECIFIED LENGTH OF TIME AFTER THE DISABILITY OCCURS BEFORE PAYMENT BEGINS.

WHERE CAN YOU ACQUIRE HEALTH INSURANCE? HEALTH INSURANCE IS AVAILABLE FROM SEVERAL SOURCES AND IN MANY DIFFERENT FORMS. YOU CAN BUY HEALTH INSURANCE AS AN INDIVIDUAL OR AS A MEMBER OF A GROUP. SOME OPTIONS ARE GROUP HEALTH INSURANCE, INDIVIDUAL HEALTH INSURANCE, HEALTH MAINTENANCE ORGANIZATIONS, AND STATE GOVERNMENT ASSISTANCE.

THE MOST POPULAR WAY TO BUY HEALTH INSURANCE IS THROUGH A GROUP. AS WITH GROUP LIFE INSURANCE, GROUP HEALTH INSURANCE POLICIES ARE MADE AVAILABLE BY EMPLOYERS TO THEIR EMPLOYEES AND BY UNIONS AND OTHER ORGANIZATIONS TO THEIR MEMBERS. THE COMPANY, UNION, OR ORGANIZATION RECEIVES A MASTER POLICY. THE MEMBERS WHO ARE INSURED UNDER THE PLAN ARE GIVEN MEMBERSHIP CARDS TO INDICATE THEIR PARTICIPATION IN THE PLAN. COMPANIES THAT SPONSOR GROUP POLICIES OFTEN PAY PART OR ALL OF THE PREMIUM COSTS FOR THEIR EMPLOYEES. THIS IS PROVIDED AS AN EMPLOYMENT BENEFIT IN ADDITION TO SALARY. THE COST OF GROUP HEALTH INSURANCE IS LOWER PER INSURED THAN THE COST OF A COMPARABLE INDIVIDUAL POLICY. THIS IS POSSIBLE BECAUSE INSURANCE COMPANIES CAN ADMINISTER GROUP PLANS MORE ECONOMICALLY, THUS LOWERING COSTS FOR EACH PERSON IN THE GROUP.

SOME PEOPLE ARE NOT MEMBERS OF A GROUP AND ARE NOT ELIGIBLE FOR GROUP HEALTH INSURANCE. THEY MAY BE SELF-EMPLOYED, FOR EXAMPLE, AND HAVE NO EMPLOYER TO HELP BUY HEALTH INSURANCE FOR THE GROUP. ONE ALTERNATIVE IS TO BUY INDIVIDUAL HEALTH INSURANCE. INDIVIDUAL HEALTH INSURANCE IS AVAILABLE TO INDIVIDUALS AND IS ADAPTABLE TO INDIVIDUALS’ HEALTH INSURANCE NEEDS. INDIVIDUAL HEALTH INSURANCE POLICIES ARE USUALLY RATHER EXPENSIVE, REQUIRE A PHYSICAL EXAMINATION, AND HAVE A WAITING PERIOD BEFORE THE POLICY IS IN FORCE.

OVER THE PAST TWO DECADES, VARIOUS ALTERNATIVES TO TRADITIONAL FEE-FOR-SERVICE HEALTH INSURANCE HAVE GROWN TREMENDOUSLY IN POPULARITY. KNOWN COLLECTIVELY AS MANAGED HEALTH CARE OR MANAGED CARE, THESE PLANS NOW COVER MORE THAN TWO-THIRDS OF Americans WHO ARE COVERED THROUGH WORK. THEY TYPICALLY PROVIDE COMPREHENSIVE HEALTH CARE AT A LOWER COST THROUGH NETWORKS OF PROVIDERS SUCH AS DOCTORS, HOSPITALS, AND CLINICS. PATIENTS BENEFIT FROM LOWER PREMIUMS, LOW OR NO DEDUCTIBLES, LOW COPAYMENTS, AND LITTLE OR NO PAPERWORK. A POTENTIAL MAJOR DRAWBACK IS THAT PATIENTS HAVE LESS CONTROL OR CHOICE OVER WHOM THEY SEE FOR HEALTH PROBLEMS AND THE SPECIFIC TREATMENT THAT IS COVERED BY MANAGED CARE PLANS COMPARED TO TRADITIONAL INSURANCE.

MANAGED CARE PLANS GO BY VARIOUS NAMES—SUCH AS HMOs (HEALTH MAINTENANCE ORGANIZATIONS), PPOs (PREFERRED PROVIDER ORGANIZATIONS), AND POS (POINT OF SERVICE) PLANS—BUT THE DIFFERENCES BETWEEN PLANS HAVE TENDED TO DIMINISH OVER TIME AS THEY ALL COMPETE FOR CUSTOMERS BY ADOPTING POPULAR FEATURES. THE GROWTH OF MANAGED CARE HAS BEEN DRIVEN BY LARGE COMPANIES, WHO ARE TRYING TO CONTROL THE RISING COST OF PROVIDING THEIR EMPLOYEES WITH HEALTH CARE COVERAGE, AND BY LARGE INSURANCE COMPANIES, WHICH ARE TRYING TO PROTECT THEIR FINANCIAL STAKES IN THE HEALTH CARE FIELD. MANY MANAGED CARE PLANS ARE RUN BY INSURANCE COMPANIES.

HEALTH MAINTENANCE ORGANIZATIONS (HMOs) NORMALLY CONSIST OF A STAFFED MEDICAL CLINIC ORGANIZED TO SERVE ITS MEMBERS. YOU MAY JOIN AN HMO FOR A FIXED MONTHLY FEE. AS A MEMBER, YOU ARE ENTITLED TO A WIDE RANGE OF PREPAID HEALTH CARE SERVICES INCLUDING HOSPITALIZATION. HMOs EMPHASIZE PREVENTIVE HEALTH CARE. EARLY DETECTION AND TREATMENT OF ILLNESSES HELP TO KEEP PEOPLE OUT OF HOSPITALS AND KEEP COSTS DOWN.

GENERALLY, HMOs DO NOT COVER TREATMENT OR CARE THAT IS NOT AUTHORIZED BY A PHYSICAL OR IF THE PROCEDURE IS ABOVE THE AVERAGE COST FOR THAT AREA. COSMETIC SURGERY, IF NOT MEDICALLY NECESSARY, ALSO OFTEN IS EXCLUDED.

THE GROWTH OF HMOs HAS BEEN RAPID; MEMBERSHIP HAS INCREASED FROM LESS THAN 2 MILLION IN THE EARLY 1970s TO MANY TIMES THAT TODAY. HOWEVER, HMOs ARE NOT THE ONLY PLANS AVAILABLE.

A POPULAR ALTERNATIVE TO THE HMO IS THE PREFERRED PROVIDER ORGANIZATION (PPO). THIS HEALTH INSURANCE DELIVERY SYSTEM INVOLVES HEALTH CARE PROVIDERS SUCH AS A GROUP OF PHYSICIANS, A CLINIC, OR A HOSPITAL CONTRACTING WITH AN EMPLOYER TO PROVIDE MEDICAL SERVICES TO EMPLOYEES. THESE PROVIDERS AGREE TO CHARGE SET FEES FOR THEIR SERVICES. EMPLOYEES ARE ENCOURAGED, BUT NOT REQUIRED, TO USE THE PPOs SERVICES THROUGH FINANCIAL INCENTIVES. THE EMPLOYEE IS USUALLY ABLE TO GET MEDICAL TREATMENT THROUGH THE PPO AT A SIGNIFICANT DISCOUNT. EMPLOYEES ARE FREE, HOWEVER, TO SEEK MEDICAL TREATMENT ELSEWHERE AND MAY BE PARTIALLY REIMBURSED FOR OUT-OF-POCKET MEDICAL EXPENSES.

AN IMPORTANT HEALTH INSURANCE PROGRAM ESTABLISHED BY STATE GOVERNMENTS IS WORKERS’ COMPENSATION. WORKERS’ COMPENSATION IS AN INSURANCE PLAN THAT PROVIDES MEDICAL AND SURVIVOR BENEFITS FOR PEOPLE INJURED, DISABLED, OR KILLED ON THE JOB. ACCIDENTS MAY OCCUR ON ALMOST ANY JOB. EMPLOYEES MAY SUFFER INJURIES OR DEVELOP SOME ILLNESS AS A RESULT OF THEIR WORKING CONDITIONS. TO DEAL WITH THIS PROBLEM, ALL STATES HAVE PASSED LEGISLATION KNOWN AS WORKERS’ COMPENSATION LAWS. THESE LAWS PROVIDE MEDICAL BENEFITS TO EMPLOYEES WHO ARE INJURED ON THE JOB OR BECOME ILL AS A DIRECT RESULT OF THEIR WORKING CONDITIONS. UNDER THESE LAWS, MOST EMPLOYERS ARE REQUIRED TO PROVIDE AND PAY FOR INSURANCE FOR THEIR EMPLOYEES.

THE BENEFITS PROVIDED THROUGH WORKERS’ COMPENSATION VARY FROM STATE TO STATE. IN SOME STATES, ALL NECESSARY EXPENSES FOR MEDICAL TREATMENT ARE PAID. IN OTHERS, THERE IS A STATED PAYMENT LIMIT. USUALLY THERE IS A WAITING PERIOD OF A FEW DAYS BEFORE A WORKER IS ELIGIBLE FOR LOSS-OF-INCOME BENEFITS. IF UNABLE TO RETURN TO THE JOB AFTER THIS WAITING PERIOD, THE WORKER IS PAID A CERTAIN PROPORTION OF WAGES AS BENEFITS. THIS USUALLY AMOUNTS TO ABOUT TWO-THIRDS OF THE WORKER’S NORMAL WAGES. PAYMENTS ARE ALSO MADE TO DEPENDENTS IF THE WORKER IS KILLED IN AN ACCIDENT WHILE ON THE JOB.

STATE GOVERNMENTS ALSO ADMINISTER A FORM OF MEDICAL AID TO LOW-INCOME FAMILIES KNOWN AS MEDICAID. THE FEDERAL GOVERNMENT SHARES WITH STATES THE COST OF PROVIDING HEALTH BENEFITS TO FINANCIALLY NEEDY FAMILIES. A FINANCIALLY NEEDY FAMILY IS ONE WHOSE INCOME PROVIDES FOR BASIC NECESSITIES BUT WHO COULD NOT AFFORD ADEQUATE MEDICAL CARE OR PAY LARGE MEDICAL BILLS.

THE SERVICES COVERED BY MEDICAID INCLUDE HOSPITAL CARE, DOCTORS’ SERVICES, X-RAYS, LAB TESTS, NURSING HOME CARE, DIAGNOSIS AND TREATMENT OF CHILDREN’S ILLNESSES, AND HOME HEALTH CARE SERVICES.

THE NATION’S SOCIAL SECURITY LAWS PROVIDE A NATIONAL PROGRAM OF HEALTH INSURANCE KNOWN AS MEDICARE. IT IS DESIGNED TO HELP PEOPLE AGE 65 AND OLDER AND SOME DISABLED PEOPLE PAY THE HIGH COST OF HEALTH CARE. MEDICARE HAS TWO BASIC PARTS: HOSPITAL INSURANCE AND MEDICAL INSURANCE.

THE HOSPITAL INSURANCE PLAN INCLUDES COVERAGE FOR HOSPITAL CARE, CARE IN AN APPROVED NURSING HOME, AND HOME HEALTH CARE UP TO A CERTAIN NUMBER OF VISITS. NO PREMIUM PAYMENTS ARE REQUIRED FOR THE HOSPITAL INSURANCE, AND ALMOST EVERYONE 65 YEARS OLD AND OLDER MAY QUALIFY.

THE MEDICAL INSURANCE PORTION OF MEDICARE IS OFTEN CALLED SUPPLEMENTARY OR VOLUNTARY MEDICAL INSURANCE. THE SERVICES COVERED UNDER THIS PLAN INCLUDE DOCTORS’ SERVICES, MEDICAL SERVICES AND SUPPLIES, AND HOME HEALTH SERVICES. THE MEDICAL INSURANCE REQUIRES A SMALL MONTHLY PREMIUM. THE FEDERAL GOVERNMENT PAYS AN EQUAL AMOUNT TO HELP COVER THE COST OF THE MEDICAL INSURANCE. SOME FEATURES OF THE MEDICARE PLAN ARE SIMILAR TO THE DEDUCTIBLE AND COINSURANCE PROVISIONS IN OTHER HEALTH POLICIES.

NO MATTER WHO PAYS THE PREMIUM, THE COST OF HEALTH INSURANCE, LIKE THE COST OF HEALTH CARE, IS VERY HIGH. IN FACT, THE COST OF HEALTH CARE HAS BEEN INCREASING TWO TO THREE TIMES FASTER THAN THE RATE OF INFLATION. THE COST OF HEALTH INSURANCE IS USUALLY DETERMINED BY AT LEAST FOUR FACTORS: EXTENT OF THE COVERAGE, NUMBER OF CLAIMS FILED BY POLICYHOLDERS, AGE OF THE POLICYHOLDER, AND NUMBER OF DEPENDENTS. YOU HAVE LITTLE CONTROL OVER YOUR AGE AND THE NUMBER OF PEOPLE DEPENDENT ON YOU. YOU CAN, HOWEVER, MAKE SURE YOU BUY ONLY THE KIND AND AMOUNT OF INSURANCE YOU NEED. YOU CAN ALSO TAKE GOOD CARE OF YOURSELF AND BE CAREFUL NOT TO ABUSE YOUR BENEFITS BY USING MEDICAL SERVICES WHEN THEY ARE UNNECESSARY.

INSURANCE COMPANIES ENCOURAGE POLICYHOLDERS TO PLAY AN ACTIVE ROLE IN "COST CONTAINMENT" OR KEEPING COSTS DOWN. THE MOST COMMON METHODS ARE COINSURANCE AND DEDUCTIBLES.

SOME POLICYHOLDERS ARE COVERED BY THEIR EMPLOYERS AND THEIR SPOUSE’S INSURANCE. INSURANCE PROVIDERS PROMOTE THE COORDINATION OF BENEFITS IN ORDER TO PREVENT TWO OR MORE INSURERS FROM MAKING PAYMENTS ON THE SAME HEALTH CARE CHARGES FOR A POLICYHOLDER.

THE HEALTH INSURANCE INDUSTRY ALSO ENCOURAGES SECOND MEDICAL OPINIONS TO ASSURE THE NECESSITY OF PROCEDURES. IT IS ALSO SOMETIMES NECESSARY TO GET A SECOND OPINION ON OUTPATIENT SURGERY, WHEN APPROPRIATE, TO AVOID IMPATIENT COSTS OF OVERNIGHT HOSPITAL STAYS.