1 / 10

Health Insurance Plans

Health Insurance Plans. Ashley & Lee Willis April 24, 2007. What is a Health Maintenance Organization? (HMO). In order to receive the benefits of an HMO an individual must pay a fixed monthly amount . With an HMO plan one may choose a primary care physician from an approved list of doctors.

kaiyo
Download Presentation

Health Insurance Plans

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Health Insurance Plans Ashley & Lee Willis April 24, 2007

  2. What is a Health Maintenance Organization? (HMO) • In order to receive the benefits of an HMO an individual must pay a fixed monthly amount . • With an HMO plan one may choose a primary care physician from an approved list of doctors. • An individual may not visit other specialists without the consent of their primary care physician • Visits to doctors or specialists who are not approved through the primary care physician, or who are not on the approved list, will not be covered. • Most visits require a co-pay ranging from $5-20. (http://www.healthinsuranceindepth.com/policy-types-hmo.html)

  3. What is a Preferred Provider Organization? (PPO) • In order to be a part of a PPO an individual must pay a monthly fee that will then allow them their choice of providers, and a network of basic medical benefits. • With a PPO a primary care physician is not required, and as a result, seeing a specialist does not require a referral. • If an individual prefers to receive health care outside the providers offered, they should expect to pay a higher co-payment than if the provider were from within the PPO network. • Essentially a PPO provides an individual the freedom of choice when visiting a doctor or specialist by cutting out the middle man. http://www.healthinsuranceindepth.com/policy-types-ppo.html

  4. What is a Health Savings Account? (HSA/HDHP) • Health Savings Accounts (HSAs). A personal tax-exempt trust account designed for the purpose of paying for medical expenses. • Money is contributed by individual and employers tax free • Users can only qualify for an HSA if they are enrolled in a High Deductible Savings Account (HDHP) • Money in an HSA account can be used for "qualified medical expenses" which include: expenses for "diagnosis, cure, mitigation, treatment, or prevention of disease." (Tech Ex p. 73) • The money in an HSA can provide coverage during periods of unemployment, medical expenses after retirement and long-term care expenses. http://www.nahu.org/legislative/HSAChangesChart.pdf

  5. Problems Getting Care Source: Consumer Reports

  6. Billing Hassles • HMO – 15% of holders reported having billing problems • PPO – 32% of holders reported having billing problems • HSA/HDHP – No billing hassles Source: Consumer Reports

  7. Cost Analysis • Top five expenses Americans incur each year • Health Care Expenses increase annually almost 10% • Employers will be unable to subsidize the cost of Health Care

  8. Cost Analysis

  9. HSA/HDHP Wealth Accumulation

  10. Our Recommendations • HSA – Healthy family who only anticipates routine health needs • PPO – Health care needs which requires specialists • HSA/HDHP – Single and healthy

More Related