“Health Insurance” Please respond to the following:
- Determine two to three (2-3) benefits of having health insurance for a family. Specify two (2) avenues through which families may obtain health insurance.
- Compare and contrast two (2) differences between health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Classify the plan that you believe would be most beneficial for the majority of insured patients. Provide
Answer preview
There are some differences between HMOs and PPOs in health insurance coverage. Firstly, under HMO coverage, a patient is required to seek attention first through his or her primary care provider. In the event the primary care provider is not able to treat the patient, the patient is referred to a network of specialists. While, on the other hand, a patient under the PPO plan has the freedom to choose which health care provider to seek attention from (Jacobson, Damico, Neuman, & Gold, 2015). Secondly, under HMO, the health care provider is directly paid by the insurance cover provider directly, but with PPO, patients pay for the services received at times especially for services sought out-of-network and raise a claim later with the insurance cover provider for reimbursement. I believe that the PPO plan would be the most beneficial for the majority of patients due to the flexibility in accessing services from preferred service providers. Under PPO, patients enjoy some level of coverage even at pharmacies.
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