No, prepaid does not mean "your card is empty of money". It means you pay for every minute - speak less - pay less, speak more - pay more, don't speak - pay nothing (not really :).
Here in US, you get some minutes included in your your monthly fee. Normal rate seem to be 500 minutes for $30, gets better every year. So, unless you talk more than 500 minutes a month, it does not matter if you talked 20 of 490 min - you pay $30.
On one hand, it's a rip-off. On the other hand, it changes usaged patterns dramatically, especially when 500 minutes come with free long distance.