Question

"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 support for your rationale.

Answer 1

The benefits of having health insurance for a family are:

• It provides you with the peace of mind that your family is secured in case of any unforeseen medical conditions or emergencies. You may always not have enough saving to meet up the medical procedures and that's where the healthcare insurances help you.
• It increases the access to better healthcare for the family and which in turn keeps you family healthy and safe.
• It increases saving as the insurance providers will bear the cost of hospitalization if need arises and you will not have to pay by yourself.
• It safeguards your finances.

The two avenues through which families may obtain health insurance are:

1. The employer of the principal members of the family may provide health insurance to the family.
2. The government may provide health insurance to family members.
3. Health insurances can also be purchase directly from insurance companies through any of their advisors or through their website.

The differences between health maintenance organizations (HMOs) and preferred provider organizations (PPOs) are mentioned below:

HMO members can only see a health care specialist such as an obstetrician, rheumatologist, cardiologist, etc. if they get a referral from their Primary Care Physician (PCP), who is also known as the gatekeeper of the services. The members cannot directly go to the specialists even if they need them in emergency and every time they will need a referral.

PPOs do not restrict their members with any such requirement of referrals and the members can directly see an specialist if they need their help.

Under HMO healthcare providers agree to provide healthcare services to members at a lower prices negotiated by the insurance companies and the list is comparatively not so large.

PPOs on the other hand provide multiple options of healthcare and healthcare services providers.

The healthcare services are comparatively cheaper under PPOs as compared to HMOs because PPOs have a vast list of network and its members get enough options to choose from according to their needs and affordability.

The plan that I believe would be most beneficial for the majority of insured patients is:

Health Savings Plan offered by Kaiser Permanente as it provides benefits such as: a network of more than 22000 participating physicians, options like classic plans, essential plans, and advantage plans, unlimited doctor’s visits, no co-pay plans, after-hours care, generic prescription drugs, and online wellness tools which is beneficial from an individual's perspective.