Features of Health Plans


Features of Health Plans
Alesha McCall
March 2, 2011
Luci Shipley

The indemnity plan allows its policyholder to choose any provider they want, at little to no cost containment. In addition, to at little to no cost containment the policyholder may have to get preauthorization for some procedures.  Indemnity also as higher costs, plans have coinsurance, and deductibles. Under this type of coverage, your preventive care not usually covered.  In Health Maintenance Organization or what is called an HMO the policyholder are only allowed to use HMO network providers. Preauthorization is required for containment, your primary care physician manages care, and No payment for out-of-network non-emergency services of any kind. HMO’s are the low co-payments and they cover preventive care but only in their network. Point- of-Service also known as POS allows you to choose between network providers or out-of-network providers.  In POS within the network, a patient’s primary care physician manages their care.  With POS if you use a provider inside the network then you will have low co-payments but if you choose to receive services outside the network then the cost is higher.  Your preventive care is also cover under POS policies. Preferred Provider Organization or (PPO) and Consumer-Driven Health Plan a very similar provider options they both allow the policyholder to use the care providers in their network or look for care outside the network.   PPO does not require a referral for the patient but they do ask for preauthorization for some procedures.   PPO does have higher cost for out-of-network providers. They have preventive care and PPO’s coverage varies. Consumer-Driven Health Plan make patient pay directly until their deductible is met. They have high deductible with low premium and savings account.   I feel that HMO’s are all for the person providing the care to the patient because it limits where the patient can go for health care.   When it comes down to...