Tuesday, November 17, 2009

The Three Different Kinds of Managed Care Plans

By J. D Theis

Managed care plans are one of the three major kinds of health insurance. The other two basic kinds of medical insurance are: Uninsured or Self-Insured, and Indemnity Plans. Briefly stated, uninsured and self-insured are the kinds of individual insurance that actually includes individuals who either has his/her own insurance and pays his/her own insurance premiums, as well as the persons who has no insurance at all. Meanwhile, indemnity plans are insurance plans that actually give you the most comprehensive healthcare, wherever you are and whenever you need it.

In this case, one of the most common health plans is managed care plans. These are actually the types of plans that provide health plan services from very specific providers. In addition, these providers also gives you contracted services according to the approved contracted prices. Try to take a look at the three different kinds of manages care plans:

1. Health Maintenance Organizations (HMOs) Health maintenance organizations are the ones who offer consumers pre-paid health related insurance plans. In return, members are required to pay specific, fixed monthly premiums. Whenever you have HMOs for your insurance, you can actually get different medical services, from visits and consultations to doctors, to hospitalizations, and even on surgeries. This is truly a helpful mechanism in times of serious diseases or illnesses.

2. Preferred Provider Organizations (PPOs) These are organizations that provide medical services to a specified group. Usually, this includes groups of doctors and health care facilities to be serviced to consumers. In this case, beneficiaries are actually paying the bills at first and then will ne reimbursed later for the costs of the treatment that was incurred. Usually, the cost of the medical treatments is agreed upon by the health care provider and the PPO.

3. Point of Service (PPS) The point of service is actually a type of managed care plan which actually gives treatments and support to members who are required to pay low premiums. In addition, beneficiaries are also not required to pay for deductibles, unlike other kinds of insurance. However, you must actually limit yourself to your network. Outside your network, you already have to pay additional charges, as well as the required deductibles.

In this case, whenever you need care, always take a close look on the different kinds of managed care and choose what fits u best. Do not take chances, and be sure to get insurance. It is for your own protection.

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