Management Care: 

A description

You will hear a lot of “organized care” terms in America. This is a way to help control costs for health insurance. Health care affects how much health you care about. Almost all health insurance plans have a regular care program to help control the healthcare costs. For example, if you need to go to the hospital, a regular management requirement that you will receive approval from your health insurance company, before you need a hospital to make sure .

Fee-for-Service Health Plans

This is a traditional type of healthcare policy. Health insurance companies pay fees for services provided to the sick people covered by the policy. The health insurance doctors and hospitals offer the highest selection of such types. You can choose any doctor who can change the doctors at any time. You can go to any hospital in any country.

With a service health plan for the fee, insurance only plays part of your doctor and hospital bills. You pay a monthly fee, which is a premium name.

Every year, the amount is known as deductible, your health insurance is paid before you start paying. In a general plan, every person in your family may have deducted $ 250, the family may have less than $ 500, when at least two people have reached individual deductions in the family. The requirement of deduction applies every year of the health insurance policy. In addition, your deductible health does not cost all the health. According to the health insurance policy, only those who do. You need to check out the health insurance policy that can be found.

After paying your deduction for the year, share with you a Blood Insurance Insurance Company. For example, you can pay 20% while health insurance plays 80%. Your part is called “scans”.

To get a payment for the service health claim for the fee, you had to fill the form and send it to your health insurance. Sometimes your doctor office will do this for you. You also need to keep the drug and other medical costs available. You are responsible for tracking your medical costs.

There are limitations to how much health insurance company will pay for your health claim, if two and two groups file a file under the health insurance plan for both you and your husband. A contract of gain gain usually limits the benefits under two health projects that are not more than 100%.

Maximum fees are “cap” in health plans for service, which you have to pay for medical bills in any year. When a pocket expense (for your deductions and your scaling), you have a certain amount to reach the cap. It can be as low as $ 1,000 or more as $ 5,000. The Health Insurance Company pays full amount in excess of the cap for your policy that it will cover. The cap does not pay for your monthly health insurance premium.

Some health services are limited or not at all. You need to check the coverage of safety care, such as immunization and well-being care of the child.

There are two types of service health coverage fees: basic and large medical. Basic protection payment of a hospital room and healthcare costs while you are at the hospital. It includes some hospital services and equipment, such as X-ray and fixed medicine. The basic coverage also indicates the cost of surgery, whether they perform in the hospital or outside, and visit some doctors. Major Medical Insurance terminates where your primary coverage is terminated. This covers the cost of long, high cost diseases or injuries.

Some health-care policies combine basic and large medical insurance coverage in one plan. This is sometimes called a “comprehensive plan”. To check out your health insurance policy, to ensure that you are for both types of protection.

HMO: Health Maintenance Organizations

A Health Maintenance Organization, or “HMO”, is a prepaid health plan. As a member of a HMO, you pay monthly premiums. In exchange, HMO provides comprehensive health care for you and your family, including doctor visits, hospitalization, emergency care, surgery, laboratory (lab) test, x ray and therapy.

HMO manages to handle this health either by directing its own group and / or by other healthcare professionals under doctors and treaty. Generally, the choices of your doctors and hospitals are limited to people who have a contract with the HMO to provide health care. However, exceptions are exclusively exclusively or necessary.

There may be a small co-payment for each office visit, such as $ 5 for a doctor’s visit or $ 25 for the treatment of the hospital’s emergency room. Your overall medical expenses are likely to be compared to the Service Health Insurance for the fee. HMO is more likely to be.

Because the HMOs receive a fixed fee for the medical care you cover, to make sure that you are interested in getting basic health care before you become serious. . HMO usually provides protective care, such as office tours, immunity, good child checking, memogram and physical. HM Oz covers various health services, so it is important to compare the HMO’s available projects. Some services, such as outpatient intelligent health care, are often limited to limited access only on a limited basis.

Many people are like HMO because they do not need a claim form for office tours or hospital residents. Instead, members offer a card like a credit card at the doctor’s office or hospital. However, in HMO you may have to wait long for a meeting with a service health insurance plan.

In some HM oz, doctors are given salary and they are offices in HMO construction in one or more places in your community, as part of all prescribed group health practice. In others, independent groups of doctors contract with patients with the HMO. They are called individual practice associations and are being made with private doctors in private offices that care for members of the HMOO. You choose a doctor from the list of participating doctors participating in the IPA network. If you think about switching to a type of HIVO, ask your doctor if they participate in the HMO project.

Almost all HMOs are assigned to you, or you choose a doctor so that you serve as your primary care doctor. This doctor monitors your health and provides maximum medical care, which requires specialists and other health care experts. You can not normally see a fitness-care specialist without your primary care doctor, without the refrigerator, who intend to get you through health care. This is a way that the HMO can limit your choice.

Before choosing HMO, it’s a good idea to talk with people that you are considering considering HDOs that are admitted. Ask them how they like services and care.

POS: Point-of-Service Plans

Many HROs are known as a point of service or a “POS” health care plan as a viewpoint. In the PLO plan basic care doctors refer to other providers in the health plan generally. But in the PSO plan, members can take themselves out of planning and take some coverage.

If the doctor refers to the network, he or she will pay a maximum of billions of health care plans. If you refer to the provider outside the network and cover the service health plan, you will have to endure it.

PPO: Preferred Provider Organizations

Priority organization organization, or “PPO” is a combination of traditional fee service and a HMO combination. Like a HMO, there are a limited number of doctors and hospitals to choose. When you use those providers (sometimes called “Preferred Provider”, “Network Provider”), your maximum medical bills are covered.

When you go to the doctors in PPO, you offer a card and do not need to fill the form. Usually there is a small payment for each visit. For some healthcare services, you will have to pay deduction and security.

With a HMO, a PPO requires you to choose a basic care physician to monitor your health care. Most PPO covers care of care. It usually consists of a doctor, well-informed child care, immunity, and memogram.

In PPO, you can use the doctors that are not part of the project and still get some health insurance coverage. At this time, you will pay a large portion of your bill (and fill out the claim of claim). Some people like this option because if their doctor is not a part of the network, it means that they will not change the doctors to join the PPP.

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