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Comparison of Health Care Plans

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Comparison of Health Care Plans There are several different health care plans available for consumers, and businesses as well as physicians. An Indemnity Plan: under this plan the insurance company which is known as the payer protects the policy holder against costs of medical services and procedures. This plan has higher costs to the consumer but also offers freedom of choice for providers. Health Maintenance Organization (HMO): Offers Limited provider network, but does cover preventative care, lower co payments, does not cover any out of network non-emergency services. Point of Service (POS): Offers in network and out of network providers, lower co-payments for in network, and higher costs of co-payments for out of network providers. Preventative care is covered. Preferred Provider Organization (PPO): Offers preferred providers you can also use out of network providers but at a higher cost. Referrals are not required for specialists, discounted fees, and need preauthorization for some procedures. Higher costs for out of network providers, preventative care coverage varies. It is my opinion that the PPO will provide more coverage for the least amount of money for the consumer but does not favor the provider; the provider is given a list of what is a covered expense and the rest they have to write off. I have a PPO for my insurance plan from my employer and I get papers from the insurance company with a detailed explanation of what is covered and what is not a covered expense.

References
Valerius, J., Bayes, N., Newby, C., & Seggern, J. (2008). Medical insurance: An integrated claims process approach (3rd ed.). Boston, MA:

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