Health maintenance organizations Essay

There be nine private on the fence(p)er syllabuss which include preferred provider organizations (PPO), wellness brinytenance organizations (health maintenance organization), point of service (POS). Indemnity plans cost the most for employees and they usually call for to choose a PPO plan. The new consumer driven health plan (CDHP) which a lot of people are picking, it has a high allowable combined with a funding option of some type. All of the plans learn unique features for coverage of services and financial responsibility. PPO plans are the most prevalent plan that doctors, clinics, hospitals, and pharmacies contract with. single of the reasons that the PPO plans are so popular is because they pay the doctors a discounted fee for service based on their fee schedule. PPO plans purport a low premium that has a higher deductible or the other option is a high premium with a set down deductible. The affected roles are responsible to pay a copayment, and there is also a year ly deductible that the patient has to pay out of pocket. If a patient watch overs a doctor outside of the network without a referral, the plan testament pay less and the patient is responsible for the remainder of the fee.Patients have their pickax of providers, but if the patient goes to a out-of-network provider it leave alone cost more. One thing to remember though is that all non-emergency services require pre-authorization. With HMO plans there is a list of providers that the patient can only go to, if they go to a doctor that is not in the list of providers they will have to pay extra. The only way that a patient should translate a provider out of the network is if it is an emergency. HMOs have an annual premium and a copayment that is due at the time of service.The main services the HMOs cover is preventive and wellness checks and malady management. However, in order for complete coverage the enrollees must see a doctor that offers an HMO plan. The providers manage the handle and referrals are demand, low payments, ad this plan does cover preventative care. The indemnity plan allows the patient to see any physician but there are preauthorizations required for some of the procedures. Their features are higher costs, there are deductibles, coinsurance payments, and preventative care is not usually covered.Consumer Driven Health Plans (CDHP) has two elements that are include in this plan. One being a health plan, which is normally a PPO. This plan has a higher deductible and lower premium. Second is the picky savings account which is used to pay medical bills before deductible is met. Point of service (POS) is similar to an HMO plan specifically called an open HMO. This plan reduces restrictions, allowing members to choose providers outside of the HMO. However, a penalty fee is charged.