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’žM a n a g e d H e a l t h C a r e : A n A l t e r n a t i v e H e a l t h P l a n I n s u r a n c e f o r I n d i v i d u a l s
from:M i s h a p s c a n h a p p e n a n y t i m e , a n y w h e r e . < b r > < b r >
I t c a n o c c u r e v e n t o t h e w e a l t h i e s t p e o p l e n o t o n l y t h e p e n n i l e s s . I t d o e s n o t s e l e c t o n l y t h e f r a i l a n d r a g g e d , e v e n t h e h e a l t h i e s t i n d i v i d u a l s c a n e n c o u n t e r a n u n e v e n t f u l c i r c u m s t a n c e i n t h e i r l i v e s . < b r > < b r >
U n c e r t a i n t y i s a f a c t o f l i f e . S i n c e y o u a r e f a c e d w i t h u n c e r t a i n t i e s i n y o u r d a i l y l i f e , i t i s b e s t t o b e p r e p a r e d a t a l l t i m e s . < b r > < b r >
Y o u n e e d t o e q u i p y o u r s e l f w i t h a h e a l t h i n s u r a n c e . N o w a d a y s , i f y o u w a n t t o h a v e y o u r o w n a n d e x c l u s i v e h e a l t h i n s u r a n c e , y o u c a n d o s o w i t h a h e a l t h i n s u r a n c e f o r i n d i v i d u a l s . < b r > < b r >
A m o n g s t t h e d i f f e r e n t h e a l t h i n s u r a n c e p l a n s f o r i n d i v i d u a l s , m o r e a n d m o r e p e o p l e a r e g o i n g w i t h a M a n a g e d H e a l t h C a r e P l a n . < b r > < b r >
A m a n a g e d h e a l t h c a r e p l a n i s a n a p p r o a c h w h e r e i n s u r e r s f i n a n c e s a n d h e a l t h s e r v i c e s a r e b e i n g t a k e n c a r e d t h r o u g h a p a r t i c u l a r h e a l t h c a r e p l a n c h o s e n b y t h e m e m b e r . M a n a g e d h e a l t h c a r e p l a n i s d e s i g n e d t o a c h i e v e t h e f o l l o w i n g o b j e c t i v e s : < b r > < b r >
1 . T o l e s s e n y o u r m e d i c a l c o s t s b u t e n s u r i n g g o o d - q u a l i t y h e a l t h s e r v i c e s . < b r > < b r >
2 . T o p r o v i d e d i f f e r e n t o p t i o n s w i t h t h e m e m b e r s w i t h r e g a r d s t o t h e i r h e a l t h c o n c e r n s . < b r > < b r >
P a r t i c u l a r h o s p i t a l s , d o c t o r s , a n d o t h e r h e a l t h c a r e p r o v i d e r s a r e b e i n g c o o r d i n a t e d w i t h m a n a g e d h e a l t h c a r e p l a n s . T h i s i s b e i n g d o n e t o h e l p a l l e v i a t e t h e a m o u n t o f m o n e y b e i n g d i s b u r s e d b y t h e m e m b e r s . < b r > < b r >
T h e r e a r e t h r e e m a j o r p l a n s u n d e r t h e u m b r e l l a o f m a n a g e d h e a l t h c a r e p l a n s . < b r > < b r >
P r e f e r r e d P r o v i d e r O r g a n i z a t i o n s ( P P O ) < b r > < b r >
H o s p i t a l s , d o c t o r s a n d o t h e r h e a l t h c a r e p r o v i d e r s a g r e e t h a t m e m b e r s p a y r e d u c e d f e e s f o r t h e s e r v i c e s t h e y a r e o f f e r i n g . < b r > < b r >
O n e g o o d a d v a n t a g e o f e n r o l l i n g y o u r s e l f w i t h a P P O i s t h a t t h e r e i s n o r e f e r r a l r e s t r i c t i o n c o m p a r e d t o o t h e r h e a l t h p l a n s . I t m e a n s t h a t y o u c a n s e e a n y p h y s i c i a n w i t h o u t s e c u r i n g a r e f e r r a l f r o m t h e n e t w o r k . H e n c e , i t i s t r o u b l e - f r e e o n y o u r p a r t . < b r > < b r >
H e a l t h M a i n t e n a n c e O r g a n i z a t i o n s ( H M O ) < b r > < b r >
I t i s b e l i e v e d t h a t H M O i s o n e o f t h e o l d e s t t y p e s o f m a n a g e d h e a l t h c a r e p l a n . T h e o r g a n i z a t i o n w i l l c o n t a c t w i t h a g r o u p o f d o c t o r s a n d o t h e r h e a l t h c a r e p r o v i d e r s t o f o r m a n e t w o r k . T h e f o r m e d g r o u p i s t h e o n e t o a t t e n d t o t h e m e m b e r s m e d i c a l n e e d s a n d h e a l t h s e r v i c e s . < b r > < b r >
Y o u a r e l i m i t e d t o s e e p h y s i c i a n s o r h e a l t h c a r e p r o v i d e r s w i t h i n t h e n e t w o r k s o t h a t t h e o r g a n i z a t i o n p a y s f o r t h e h e a l t h a n d m e d i c a l s e r v i c e s y o u a t t a i n e d . O t h e r w i s e , y o u d o l e o u t m o n e y i f y o u h a v e s e l e c t e d a p h y s i c i a n o u t s i d e o f t h e n e t w o r k . < b r > < b r >
P o i n t - o f - S e r v i c e ( P O S ) P l a n s < b r > < b r >
F r e e d o m o f c h o i c e t h i s i s w h a t P O S c a n d o f o r y o u . P o i n t - o f - s e r v i c e i s a m i x t u r e o f H M O a n d P P O . Y o u h a v e t h e o p t i o n t o s e l e c t w h i c h s u i t s y o u r i m m e d i a t e h e a l t h n e e d . < b r > < b r >
S i m i l a r t o H M O a n d P P O , P O S f o r m s a g r o u p o f d o c t o r s a n d h e a l t h c a r e p r o v i d e r s t o a t t e n d t o y o u r m e d i c a l n e e d s . H o w e v e r y o u h a v e t h e o p t i o n w h e t h e r o r n o t t o c h o o s e a p h y s i c i a n w i t h i n t h e n e t w o r k . I f y o u s e e k t o c o n s u l t w i t h a p h y s i c i a n o u t o f t h e n e t w o r k , P O S w i l l s h a r e w i t h y o u r m e d i c a l e x p e n s e s . H o w e v e r e x p e c t t o h a v e h i g h p a y m e n t s f o r c o i n s u r a n c e a n d d e d u c t i b l e s . < b r > < b r >
D o n t l e t a c a t a s t r o p h e r u i n y o u r l i f e . T h e r e m a y b e i n s t a n c e s t h a t i t c a n n o t b e p r e v e n t e d s i n c e n a t u r e h a s c o n t r o l o v e r i t b u t y o u c a n d o s o m e t h i n g a b o u t i t a f t e r i t h a s c r a s h e d i n t o y o u r l i f e . E q u i p p i n g y o u r s e l f w i t h o n e o f t h e t y p e s o f m a n a g e d h e a l t h c a r e p l a n e n s u r e s u t m o s t h e a l t h a t t e n t i o n a n d t r e a t m e n t w h e n y o u m o s t n e e d i t . M o r e o v e r , y o u n e e d n o t w o r r y o f w h o t a k e s c a r e o f y o u r m e d i c a l f i n a n c e s a n d s e r v i c e s m a n a g e d h e a l t h c a r e p l a n w i l l d o i t a l l f o r y o u . < b r > < b r >
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