Question

Ralph says he pays $960 per month for his employer’s HMO plan. Since the employer also offers a PPO and POS plan from another insurance company, why doesn’t Ralph switch plans? Explain in detail.

Answer 1

Ans. Ralph won't switch plans because he might consider his situation favorable towards talking this plan only and advantages offered by HMO plan must also be inline towards his need. Some of the benefits that HMO gives to Ralph for which he's not ready to switch to another plans are :

1. HMO include both Medicaid and privately insured patients.

2. Ralph is likely to pay very less Premium for an HMO compared to other insurance programmes.

3. Ralph do not have to face High Deductibles.

4. Ralph would be assured for the period because monthly payment would not increase depending on the use of Healthcare System.

5. Ralph's primary care physician and other providers would be in the HMO network.

6. Only medical necessary services are approved in HMOs which assists in monitoring and maintaining costs.