3. Private health insurance - Comparison of plans and providers Aa Aa E In the United States, private health insurance plans can be written as group or individual plans, or as indemnity or managed care plans. Comparing Private Insurance Plans Joachim is able to secure health insurance because he is a member of his credit union. This is an example of a group insurance plan. Indemnity, or fee-for-service, plans and managed care plans cover medical expenses if you are sick or injured, but in different ways. The following questions examine the general differences between the two plans. Taking a closer look at how these plans provide coverage will help you begin to customize a health care plan that best suits your requirements. Select the plan that most closely matches each given description. Indemnity plan Managed care plan 0 0 Insureds are subject to an annual deductible Usually lower premiums Out-of-pocket costs generally include the plan's deductible and 20% of the plan's covered medical expenses The premium represents a prepayment for one's own health care More likely to cover preventative and routine care ooo 0 Now that you've taken a closer look at the differences between these types of plans, consider the following statements. Each indicates common preferences and situations. Select the type of plan to which each statement most closely aligns. Indemnity plan Managed care plan I'd rather receive my health care from a group of pre-screened providers who meet specific selection standards. I'd rather have the flexibility of either having the insurance company reimburse me or directly paying the health care provider. I most value the freedom of choice and am willing to pay for it. O There are several types of managed care plans, including group health maintenance organizations (group HMOs), individual practice associations HMO (IPA HMOs) preferred provider organizations (PPOs), exclusive provider organizations (EPOS), and point-of-service (POS) plans. Deciding which particular type of practice would best meet your needs requires knowing the major characteristics of each. Therefore, identify the particular form of private health care organization or plan described by the following three clues: Clue #1: Under this health care plan, doctors provide medical services in their own offices or in an affiliated local community hospital. Clue #2: I will pay a $5 to $30 copayment each time I want to receive medical services or a prescription under my plan. Clue#3: Many of these plans no longer require me to select a primary care doctor. If I want my plan to exhibit these characteristics, then I should purchase: O a Blue Cross/Blue Shield plan O a group HMO an IPA HMO 3. Private health insurance - Comparison of plans and providers Aa Aa E In the United States, private health insurance plans can be written as group or individual plans, or as indemnity or managed care plans. Comparing Private Insurance Plans Joachim is able to secure health insurance because he is a member of his credit union. This is an example of a group insurance plan. Indemnity, or fee-for-service, plans and managed care plans cover medical expenses if you are sick or injured, but in different ways. The following questions examine the general differences between the two plans. Taking a closer look at how these plans provide coverage will help you begin to customize a health care plan that best suits your requirements. Select the plan that most closely matches each given description. Indemnity plan Managed care plan 0 0 Insureds are subject to an annual deductible Usually lower premiums Out-of-pocket costs generally include the plan's deductible and 20% of the plan's covered medical expenses The premium represents a prepayment for one's own health care More likely to cover preventative and routine care ooo 0 Now that you've taken a closer look at the differences between these types of plans, consider the following statements. Each indicates common preferences and situations. Select the type of plan to which each statement most closely aligns. Indemnity plan Managed care plan I'd rather receive my health care from a group of pre-screened providers who meet specific selection standards. I'd rather have the flexibility of either having the insurance company reimburse me or directly paying the health care provider. I most value the freedom of choice and am willing to pay for it. O There are several types of managed care plans, including group health maintenance organizations (group HMOs), individual practice associations HMO (IPA HMOs) preferred provider organizations (PPOs), exclusive provider organizations (EPOS), and point-of-service (POS) plans. Deciding which particular type of practice would best meet your needs requires knowing the major characteristics of each. Therefore, identify the particular form of private health care organization or plan described by the following three clues: Clue #1: Under this health care plan, doctors provide medical services in their own offices or in an affiliated local community hospital. Clue #2: I will pay a $5 to $30 copayment each time I want to receive medical services or a prescription under my plan. Clue#3: Many of these plans no longer require me to select a primary care doctor. If I want my plan to exhibit these characteristics, then I should purchase: O a Blue Cross/Blue Shield plan O a group HMO an IPA HMO