In: Operations Management
Explain the different types of health insurance programs. What are the main differences among these programs? How are they similar? Be sure to use terms that are unique to benefits, compensation, and human relations
For the present health conditions and environment health insurance is very important for everyone.because if everything is lost can regain but in terms of health nothing can be done. This is the main reason for emerging heath insurance services industry.There are number of health insurance plans which are providing based on requirement and issues and benefits needs to be selected for better health management for individual and family etc.
Insurance Plans |
Differences |
Similarities |
Benefits |
Compensation |
Human Relations |
Preferred Provider organization(PPO) |
Provide best flexibility to choose physicians and other options in this plan. Needs to select hospitals with in the network. Is a group health policy. |
Covers all kinds of issues in this plan. Is a group health policy Flexibility in choosing physicians |
Lower premium and greater benefits in the plan and option to select to see a specialist. Selecting network will be benefited. |
If someone wants to go for outside of the network hospitals result in a higher out of pocket cost. |
As per the plan its good for human relations.But better to consider few like PCP referrals is little favourable would be advantage |
Health Maintenance Organization(HMO) |
If specialist needed than primary care physician referral is required. Group health policy. |
Is a group health policy. Flexibility in choosing physicians |
Great benefits with low premium Provide benefits to the plan members at discounted prices. |
Copayment is required for certain services. Need to pay a percentage of amount for their medical expenses |
Its main aim to maintain health good as per human relations |
Point of Service(POS) |
It's the combination of both HMO and PPO plans . Primary care physicians referrals are required If services acquired in non network higher level of coverage receive |
Similar to PPO and HMO |
PCP referrals are not considered for deductible from plan. Great chance of avail services in non network hospitals |
PCP charges are not collected from the Plan. Non network charges are very low. Needs to submit a claim for reimbursement |
Its good to have a plan but needs to lower the charges at network hospitals for better usage |
Exclusive Provider Organization(EPOs) |
In case of emergency they can use non network hospitals |
These plans are similar to HMO PCP referrals required in network specialists. |
EPO members needs to pay low amount as co payment |
Low co payments and |
Benefited in terms of co payment . For considering better human relations |
Health Savings Account(HSA) |
This is a tax saving account. High deductible health plan to pay for qualifying medical expenses. |
Its a group health plan |
Tax free, Interest provided for unused funds in the insurance every year. |
It's completely tax free account. Apart from that interest will be added every year for unused funds. |
It's completely going according to human relations and think of human well being |