Question

Discuss the advantages and disadvantages to Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Fee-for-Service (FFS) insurance plans. Of these three insurance plans, which one would you prefer to have and why?

Answer 1

Health Maintenance Organization(HMO)
This is an organization that provides health insurance coverage monthly or annual fees to avoid higher health care costs.
Advantages:
-It does not need a claim form to meet the doctor
-There will be free of choice
-Low cost of pocket expenses
-It includes both medical and private insurance patients.
Disadvantages:
- It restricts the medical provider preference for the patient
-It avoids specialized care
-It has the most restive type of health care
-there is long waiting for the medical services
Preferred provider organization(PPO)
It is a managed care organization that provides treatment at less cost
Advantages:
-It provides complete flexibility
-It allows specialized care without reference
-It allows more participants to choice
Disadvantages:
-There is a high cost for physician and hospital outside the network
-There are high deductible and co-insurance
Fee for service(FFS)
It is a payment model for services to be paid separately when there is additional treatment required other than routine treatment.
Advantages:
-There is an unlimited choice for doctors
-there is less waiting for nay treatment with specialized care
Disadvantages:
-This is an expensive health insurance plan
-High deductible and co-insurance plan
-There is no coverage for an annual, physical, educational program
-Insurance will not pay for any additional services.
I prefer PPO. because It is more flexible and provides more coverage. we can see the physician without reference, it has a copayment for medical care. It also has an annual deductible and higher premiums.