Financing and Structuring Health Care

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Financing and Structuring Health Care (1) Three main types of Health Insurance: The three major types of health insurance available in the US are "Health Maintenance Organizations--HMOs, Point of Service plans--POS, Preferred Provider Organizations --PPOs." (Health Insurance Coverage, 2010) All the three coverage options come under managed care plans wherein the health insurers collaborate with healthcare providers to build networks. HMOs offer the most economical health insurance coverage, however their plans are not always flexible. As they come under HMO purview the insured has to pay monthly premium while the co-payments are relatively low for hospital and subsequent office visits. When an insured belongs to an HMO, there is a restriction to visit doctors within his network only and any failure will entail footing the bill by the insured himself. Prior to visiting Specialist Doctors, HMOs often need the insured to get referrals. Even visiting the Emergency Room needs approval if one belongs to an HMO. (Health Insurance Coverage, 2010) Nevertheless HMOs' fixed rates encourage them to offer outstanding coverage for health improvement as well as preventive care services. POS plans are comparable to HMOs on the aspect that their domain is healthcare networks. In case the insured primary care doctor refers him to a doctor outside the network, the insurance company will honor major part of the bill. Also, if the insured refers himself to a doctor outside his network, the
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