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Understanding the U.S. Healthcare System

 

This amounts to Fee for Service plans having the most expensive premiums out of all the plans, and also services must be paid for out of pocket before any services can be reimbursed. My friend will also have to have the responsibility in filling out any claim forms and basically be responsible for all necessary paperwork. The other disadvantage to this plan is it has very little concern for preventative medicine and care (WebMD, 2014, p. 2). As there is now a growing need for people to be accountable for their own health I think this is a service that should be very much available for the young so they receive the right education and services to start them off with good habits and lessen the chance of serious disease.
             HMO which stands for Health Maintenance Organization is a network of providers that have contracts with certain insurance companies that establish a fixed price. These HMO's are becoming increasingly popular as they were crated to maintain healthcare costs. They do however have more rules such as you will have to pick a provider in their network or you will not be covered. Their main advantage is they have the least expensive co-payments, sometimes these are actually free, and there premiums are lower compared to other plans (WebMd, 2014, p.2). As less out of pocket expenses are what many people nowadays are looking for this is a huge selling point when deciding on a HMO. The one disadvantage is that HMO's are designed for profit which results with the providers being very busy as they have to see enough patients so they can make that profit. If they don't it will result in them having to close. So instance access to the provider is not always possible, it can mean wait times, as well as having to wait to see a specialist as a referral is necessary unlike with the Fee for Service plans.
             Preferred Provider Organizations (PPO's) are very similar to the HMO plans. They also have similarities to the Fee for Service plan as they allow you to see the provider of your own choosing.


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