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Medical Plan Comparison Paper

1203 words - 5 pages

This Paper will be examining and comparing three different medical plans. The three medical plans to be discussed will be the Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Exclusive Provider Organizations (EPOs). This paper will be analyzing cost consideration of each plan. The flexibility of each plan will also be discussed and how accessible is the plan to participants.The differences between health care givers and the companies that provide the health care insurance have blurred substantially. A decade ago managed health care organizations was referred to as an alternative delivery systems. However, today in the United States, managed health care organizations are now the leading form of health insurance coverage. Every individuals currently living in the United States of America has a need for affordable and accessible health care coverage. Over the last thirty to forty years, the extent and cost of health care coverage have significantly changed; therefore, altering the method in which health care is managed (Corporate Information website).The Health Maintenance Organizations (HMOs) began because of the growing concern of the health care costs in the 1960s. The government was pressured to intervene.The "HMO" term was created in the early seventies as the administration in power was strategizing to endorse prepaid health plans as a solution to the nation's health system concerns. Federal legislation was created in the 1973 Health Maintenance Organization Act. This act encouraged the HMO popularity by removing legal barrier that could impede their growth (Corporate Information website).A health maintenance organization (HMO) is a type of managed healthcare system. HMOs are here to reduce health care expenditures by focusing on precautionary or preventive care and applying management controls. HMO provides financing for medical care and actually delivers the treatment needed. That makes them different from the traditional insurers. HMOs business includes hospitals, Doctors, and the insurers. Medical treatment is supplied on a prepaid basis. There is a predetermined monthly payment that is made to the HMO insurer. The participant of the monthly HMO payment can receive doctors' office visits to a mixture of medical services, including hospitalization. However, HMO's participant must pick their doctors and medical facilities from the HMO network. HMO's participant must also pick from the network a primary care physician, known as a PCP. The PCP must be contacted first for all medical concerns. With this type of control in place HMOs costs do not increase as fast as other plans (Health Insurance. 2005).Here are the positive aspects of an HMO:Members pay a fixed monthly fee and can use the doctors and medical facilities as much as a member.No deductible; preventative care.Health education classes.Health club memberships discounted.No limit on a member's lifetime benefits.The negative aspects of an HMO...

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