When it comes to classifying the health plans use the term civil liability insurance and managed care insurance. Before we explore and compare these types of plans, we want to mention here that all insurance plans share the same fundamental similarities. For example, all health plans have the characteristic of the monthly, quarterly, or annual that can be paid in cash, check and credit card or debit card or automatically through bank transfer. These payments vary by plan, age of the insured, features included in the plan and if the insured have any pre-existing medical condition. In addition, there are often other payments you must do, that vary by plan. Most health insurance plans are also characterized by some out of pocket expenses as a co-payment. A co-payment is the amount the insured pays in advance, while in a doctor's visit. Co-payments also vary with the patient and the nature of the doctor's visit.
This type of insurance plan offers a wider variety of doctors and specialists. There is also more variety to choose from as far as hospitals. Patients who are covered by indemnity plans are billed by any outside cumulative disbursements from their doctors visits and other additional charges only after the charges have been incurred and billed.
The managed care plans
These health plans are to work organization that a group of doctors, hospitals and health care providers who come together to give health care to its members at discount prices. These providers have a variety of doctors, specialists and hospitals to choose and that choice can be made easily by simply entering the zip code for one in your website and all physicians who participate in the plan will be displayed. For updates of psychotherapy need to be provided by the therapist and the sessions are given to groups that need more applications.
The managed care plans are also renowned for providing excellent care at discount rates. Members pay a low co-pay, usually between $ 10 and $ 50.00. The co-pay for dental and vision care co-payments are generally slightly more expensive and can vary by hundreds of dollars, even thought the care itself is still at a reduced cost.
Another advantage gained by the members of managed care is that they have less paperwork to deal with. Recent technological developments in the managed care system has automated the most basic tasks and members can complete all necessary paperwork right on the Internet. This is very convenient and saves time for the managed care provider and the member.
There are two main types of managed care plans: HMO and PPO
-HMO (Health Maintenance Organization) This type of managed care works through a group of doctors, medical personnel and facilities and works directly for the HMO. Each patient should choose your doctor, known as a primary care physician or PCP, the patient becomes a point of reference for the care of every patient's health needs. HMO patients experience lower premiums, primarily because the cost of care is distributed among all members. As mentioned earlier, HMO members have less paperwork to deal with because everything is automated online.
A downside of HMOs is that patients have to get a referral from your primary physician ( "permission") before they can see a specialist. This can be risky if the patient is in an emergency situation because time is wasted.
OPP participants Provider Organization or Preferred Provider Organization, is a type of health plan that is very similar to the HMO in which doctors, hospitals and providers of health care have combined to provide managed care for granted.His logic is built around the fact that they can charge less and therefore get more patients are attracted by low prices.
The idea of a preferred provider organization is that suppliers offer the insured group members a substantial discount below their regularly-charged rates. This will be mutually beneficial in theory, the insurer's PPO work by negotiating with healthcare providers to handle disputes between insurers and providers of advertising agreement with all the issues of fees. It is important to compare your area to see what the premiums are, and the providers and what is included.