Essays on Health Maintenance Organization

1. What is the plan year (effective dates)? The Aetna Student Health Insurance plan effective dates, which indicate annual policy year, run from 1st August to 31st July the following year. In the current annual policy year, the effective dates run from 1st August 2016 to 31st July 2017 (Penn State, para 4). There are two enrollment deadlines within annual policy year whereby the deadlines fall in 31st August while the spring enrollment deadline is on 31st January of the year that follows. 2. Whether My Plan Is HMO, PPO or Traditional Indemnity Type The Aetna Student Health ...

Choosing the best health plan for patient care is one of the most difficult decisions for some patients and their families because of the fine line distinguishing which plan suits them best. However, every plan is designed to suit a patient according to the kind of treatment they need, the cost of the treatment and the insurance covering every kind of treatment plan. Therefore, there are three main kinds of treatment plans that are offered in general, namely, HMO, PPO, and POS (Web MD, 2016). There are fine differences between the three, based on the need of primary physician ...

The need for an insurance plan is necessitated with the need to have timely and proper medical care in the event of an illness or an accident. In this respect, there are three basic types of health insurance medical plans that are utilitarian in serving different purposes. These health insurance medical plans can be differentiated from one another with regards to their salient features. This paper canvases the differences between Preferred Provider Organization (PPO), Health Maintenance Organization (HMO) and Point of Service (POS) plans. The paper also seeks to institute some of the pros and cons of the above ...

Within the United States of America, the appeal of managed care has increased sufficiently as a method of healthcare administration. The development of managed health care is an attributed backlash to the traditional U.S. health care system (Sekhri 2000). The managed care organization is employer-based offering indemnity insurance and fee-for-service conditioned for both the providers’ and patients’ expectation of the unlimited resources and unrestricted choice (Sekhri 2000). The system is enforced by both user and provider satisfaction through adequate compensation and consumers through unrationed medical care. Methods used in the managed health care organization are consumer oriented for equal benefit. ...

Introduction

Health insurance is a complex marketplace. It is not always easy for a common man to understand all the clauses of a typical health insurance plan. That is why often people are either not covered fully or end up paying a very high premium for the basic coverage. This essay will explore various health plans available in the market and then recommend health plan options to a family of four. This essay will then further inspect the expected changes due to the implementation of Affordable Care Act in 2014.

Research of Various Insurance Offerings

There are many types of insurance plans available in the market. The Preferred Provider Organization ( ...

HMO Plan

Currently I have an HMO health insurance coverage plan. HMO is an abbreviation of Health Maintenance Organization. An HMO offers managed care for healthcare insurance, self-funded health benefits plans, individuals, and other entities in US and closely operates with healthcare providers including hospitals and doctors on a prepaid basis. According to the Health Maintenance Organization Act of 1973 (as cited in Sautter, 2014, p.na), employers with 25 or more employees are required to provide federally certified HMO options if the employer deals with traditional healthcare plans. As reported in Obama Care Facts (n.d.), it is interesting to note that an ...

Health maintenance organization is a kind of managed health insurance or healthcare whereby the insured individuals only doctors, physicians and specialists who are part of a network. This paper seeks to focus issues that arise because of managing health maintenance organizations (Ehealthinsurance.com, 2014). The need to read this paper is to have a clearer idea of what the program concerns. Health maintenance organizations have participated in a major role of maintaining a higher standard of healthy living for the society. We will embark on their benefits and demerits, the challenges associated, and their recommendations. - Benefits of Health Maintenance Organizations: - Healthcare ...

Introduction

Health insurance is a form of insurance cover that caters for surgical and medical expenses that are incurred by the insured. Health insurance can either pay the care provider directly or reimburse the insured for expenses incurred from injury or illness. Some employers use it as a non-monetary benefit package to attract highly qualified employees. There are various types of health insurance plans. Nevertheless, all plans are expected to offer a minimum level of coverage. Some plans are comprehensive implying that they provide a variety of services. The coverage offered could be dental coverage, maternity coverage and prescription drug coverage. The various types ...

Insurance is a vital aspect and an extensive industry in the market. Its main function is to protect against future risks and losses for instance accidents, fire, floods, disability; health related issues, as well as death. It can also be detailed as a financial protection against any risks that may arise in an uncertain future. The insurance industry is wide and covers various areas of the economy for instance transport, health and even businesses among others. Traditionally, insurance has been characterized as covering two types of risk. The first is pure risk, which is one that has only a single chance of ...

Literature review for insurance

Introduction

Insurance is a broad industry in the market that enables people in managing risks associated to various uncertain events. The insurance industry helps in providing cushion against financial losses that result from various uncertain future events such as fire, floods, theft, disability or health related expenses. The insurance industry thus covers different sectors of the economy including the health care sector. Matters dealing with the health of individuals are uncertain and hence insurance helps people to be able to cover medical expenses in the event of an illness. Most of the health insurance industries have different plans to ensure ...