MEDICAL INSURANCE



TABLE OF CONTENTS

I. MEDICAL INSURANCE3

II.Introduction3

III.Comparison of Insurance3

IV.CONCLUSION6

V. REFERENCES8

Medical Insurance

Introduction

Whether an employee receives health insurance through his/her employer or purchases it on their own, they may have an opportunity to choose between several options. Understanding different types of health plans is first step in making the good choice for them and their families. The three medical plans are HMO, PPO, and POS. The cost for both employer and employees, flexibility of plan choices and benefits, and accessibility, limitation to participants will be analyzed.

Comparison of Insurance

Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO) are two of most popular medical plans provided by employers and chosen by employees. These two plans are basically same except for certain changes for employer and employee. An HMO plan provides employers the way to take care of their employees healthcare needs with reduced cost by negotiating with specific doctors, hospitals, and clinics. These specific providers must be used by employee for reduced fees to be provided to his or her medical insurance plan. In the PPO plan, employer can also provide healthcare to employee at reduced costs. However, employee has option of seeing the medical provider in network or out of network. A provider in network, similar to HMO, is one who has been previously negotiated with by employer. If an employee with the PPO plan decided to go out of network, employee would then pay the higher out of pocket cost.

A type of managed care healthcare plan is Point of Service (POS. POS employees can choose their own Primary care physician (PCP) , these physicians agree to provide services to them at discounted costs to their health insurance plan. The employee can choose between an in-network and out- of- network provider. POS plans are similar to Health Maintenance Organization HMO plans. Health plans let ...