According to Henderson, “Managed care is a term used to describe any number of contractual arrangements that integrate the financing and delivery of medical care” (Henderson, 2012). There are three common types of managed care plans: Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), and Point-of-Service (POS) Plans. One of the advantages of managed care plans is, they use of a variety of physicians and specialists in the provider’s network.
Health Maintenance Organizations (HMOs) are health care plans that negotiate with providers and facilities to provide services at a discounted rate. They provide medical care from an approved network of hospitals, doctors and pharmacies. In this plan, the patient pays a copayment for each visit. If a patient needs health insurance and decides to enroll in a Health Maintenance Organization (HMO), they will pay lower premiums or co- pays. Along with lower payments, they also choose a primary physician, if a specialist is needed, they will be referred to a specialist within the Health Maintenance Organization (HMO) network.
Most Health Maintenance Organizations (HMO) do not fit into one set category, just like any other organization, there are different plans that to make up an entire managed care plans. In a Group Model HMO, the physicians are not paid directly, the payments are made …show more content…
With Point-of-Service (POS) plans, you will not pay a deductible provided by the specific network in which you select; however, you do pay a small amount for each visit made. What is the enrollee’s costs if they go outside of the network? After reading and comparing all of the manage health plans, POS insurance policies are similar to HMOs but offer more
Health Maintenance Organizations (HMOs) are health care plans that negotiate with providers and facilities to provide services at a discounted rate. They provide medical care from an approved network of hospitals, doctors and pharmacies. In this plan, the patient pays a copayment for each visit. If a patient needs health insurance and decides to enroll in a Health Maintenance Organization (HMO), they will pay lower premiums or co- pays. Along with lower payments, they also choose a primary physician, if a specialist is needed, they will be referred to a specialist within the Health Maintenance Organization (HMO) network.
Most Health Maintenance Organizations (HMO) do not fit into one set category, just like any other organization, there are different plans that to make up an entire managed care plans. In a Group Model HMO, the physicians are not paid directly, the payments are made …show more content…
With Point-of-Service (POS) plans, you will not pay a deductible provided by the specific network in which you select; however, you do pay a small amount for each visit made. What is the enrollee’s costs if they go outside of the network? After reading and comparing all of the manage health plans, POS insurance policies are similar to HMOs but offer more