Question

In your own words, describe the differences between PPOs, POSs and HMOs. Use complete sentences. If you need assistance, use only the textbook as a reference. No reference is needed since this will be your only source. 

Answer 1

PPO

• PPO stands for Preferred Provider Organization plans or Participating Provider Organization
• Here a group of doctors ,healthcare professionals, hospitals have agreed to care a patient under a insurer
• This is the most commonly used plans.
• Most selected plans in  individual market and family market.
• It provides healthcare service at a low rate
• This allows selection of any providers within the network or as per the wish without any reference from path primary are physician
• In network services are provided with a higher benefits than out services
• Enables to choose any medical facility
• Pay deductibles before coverage starts
• Should undergo utilization review for out patient surgery

POS

• stands for Point Of Services
• It is a mixture of PPL and HMO
• Need to select a primary care  provider
• Can visit provider even who are not in network
• A greater amount of deductible, Co payment ,Co insurance to be done
• If patient goes for service out of network then they are completely responsible for thing from filling forms to maintaining receipts

HMOs

• HMO stands for Health Maintainace Organization
• Covers a broader range of preventive healthcare services
• It has providers as a network
• A primary care physician has to be selected
• Referrals can be done only after the approval from the primary care provider
• not neede to pay deductibles before the start of the coverage
• The co- paymentswill be minimal