Types of Healthcare Plans

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    • Health care plans help patients afford expensive carehealth concept image by drx from Fotolia.com

      Health care plans, also known as health insurance, spread the risk of having to pay for a catastrophic illness or injury across a group of people. Each plan member pays a premium to be covered each year. Most people will use less health care than their premium covers and the excess is used to pay for those with unusually high health care costs. There are many different plans, with different benefits and methods to control the costs of the plan.

    Fee-For-Service

    • Under a fee-for-service plan, the insurance company pays the health care provider a fixed fee for each covered service it provides to a patient covered by the plan. This type of plan will usually includes co-payments or deductibles that the patient must pay before receiving services.

    Health Maintenance Organization

    • A Health Maintenance Organization (HMO), is an organization that tries to keep the cost of insurance low by managing the patient's care. Patients are often required to see a primary care physician and receive a referral before they can see a specialist. HMO's also require that patients get costly procedures approved in advance to ensure they are necessary.

    Preferred Provider Organization

    • A Preferred Provider Organization (PPO) is a network of doctors, hospitals and other health care providers who have contracts with an insurance company. These contracts include negotiations for discounts on the cost of services and procedures that save the insurance company money. Patients with this type of health care plan are required to visit a health care provider within the PPO network. If they see someone outside of the PPO network, the care may not be covered, or the patient may be required to pay the difference between the lower cost he would have paid, had he been treated by an in-network provider, and the actual cost of the service.

    Indemnity

    • Indemnity plans pay out a fixed amount to the insured for each injury, illness or covered treatment without regard to the actual cost of the treatment. The money is paid directly to the patient, the plan manager does not deal with the health care provider and the patient is responsible for any difference between the billed cost of treatment and the pre-agreed amount paid to the provider by the plan.

    Health Discount Plan

    • Health discount plans are not health insurance at all, but offer plan members some advantages over those not covered by an plan. The health discount plan negotiates with health care providers for lower rates on services, much as a health insurance company does. Plan members receive these discounts whenever they receive health care from a participating health care provider. Health discount plans may also give discounts on prescription drugs, eye care and dental care.

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