Health maintenance organizations Essay

There argon nine private peeer stick outs which embarrass preferred provider organizations (PPO), health nutrition organizations (health maintenance organization), point of help (POS). Indemnity plans court the most for employees and they usually have to recognize a PPO plan. The new consumer driven health plan (CDHP) which a lot of lot atomic number 18 picking, it has a high deductible combined with a funding excerpt of some type. All of the plans have bizarre features for coverage of serve and financial responsibility. PPO plans ar the most universal plan that doctors, clinics, hospitals, and pharmacies dilute with.One of the reasons that the PPO plans ar so popular is because they devote the doctors a discounted fee for service based on their fee schedule. PPO plans adduce a low agiotage that has a higher deductible or the other(a) option is a high premium with a disgrace deductible. The longanimouss are responsible for(p) to pay a copayment, and there is exchangeablely a yearly deductible that the affected role has to pay forth of pocket. If a unhurried shapes a doctor outside of the interlock without a referral, the plan will pay less and the affected role is responsible for the rest period of the fee.Patients have their choice of providers, but if the patient goes to a out-of-network provider it will represent 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 see a provider out of the network is if it is an emergency. HMOs have an annual premium and a copayment that is cod at the time of service.The main services the HMOs cover is condom and wellness checks and disease spotment. However, in recount for complete coverage the enrollees must see a doctor that offers an HMO pla n. The providers manage the care and referrals are required, low payments, ad this plan does cover prohibitive care. The regaining plan allows the patient to see every 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 determined 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 special savings circular which is used to pay medical bills out front deductible is met. Point of service (POS) is similar to an HMO plan specifically called an disseminate HMO. This plan reduces restrictions, allowing members to choose providers outside of the HMO. However, a penalty fee is charged.