Comparison Of Health Plans: Advantages And Disadvantaged Care Organizations

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Comparison of Health Plans Allison Hershberger HCR/230 September 22, 2013 Jill Frawley Comparison of Health Plans PPO stands for preferred provider organization and is a managed care organization of medical doctors, hospitals, and other health care providers who have a binding agreement with an insurer or a third-party administrator, which usually pay participating providers based on a discount from their physician fee schedules, called discounted fee-for-service (Valerius et al, 2008). Providers in the PPO will provide the insured members of the group a substantial discount below their regularly-charged rates. These arrangements help to ensure that the insurer will be billed at a reduced rate when it’s insured utilize the services…show more content…
POS members may choose from a primary or secondary network. Furthermore, if a doctor refers a patient out of the network, usually the plan pays all or most of the bill. If a POS member refers themselves to doctors or specialists outside the network, they will have to pay a predetermined amount of coinsurance. POS plans charge an annual premium and a copayment for office visits ( Valerius et al,…show more content…
The significance of a high-deductible health plan is that it covers catastrophic losses, while the savings account pays out-of-pocket, non-covered or medical expenses. Therefore, consumers will be less inclined to use money for minor medical issues and make informed choices, which will help keep cost down. HEALTH REIMBURSEMENT ACCOUNT: Health reimbursement accounts (HRAs) are plans that reimburse employees for qualified medical expenses, which are usually funded by the employer. A health reimbursement account reimburses you for qualified medical expenses up to an account balance. ( Valerius et al, 2014). Qualified expenses can include Deductibles, co-payments, coinsurance and prescription drug expenses (U.S. Department of Treasury,2011). FLEXIBLE SPENDING ACCOUNT: Flexible Spending Accounts (FSA) are accounts that can be used to pay off medical expenses not covered by health insurance. FSAs allow members to use pre-tax dollars for certain eligible medical and dependent care expenses. Members fund their FSAs with contributions that come out of their paycheck (Regence, 2011).

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