Question

Discuss the major differences between a standard health insurance package and an HMO, in terms of total medical care use and financial risk to consumers

Answer 1

A standard health insurance plan in the US is one where the individuals are covered against any medical risk. Usually it can be seen that the HMO is less flexible than the standard plan. This means that it reduces the financial risk better than a regular HMO. HMO or Health Maintenance Organisation is famous because of the low premiums that it charges when compared to other most used plans like PPO. HMO is used when the individual is sure about going to the doctors in the network as there is very less flexibility in the plan. This increases the financial risk to the individuals if they have to go visit a particular specialist. This specialist has to be referred by the primary doctor otherwise will not be included. It would be safe to opt for a HMO if the individual's regular health provider is listed in the network.

There are many plans km the US like PPO, HSA, EPO, POS. Plans like EPO and POS are more flexible than HMO as there is freedom to choose the health care provider.