Hca Check Point, Health Care Plans

Hca Check Point, Health Care Plans

Check Point Features of Health Plans


Describe the similarities and differences among the major types of health plans. Do you believe any one plan offers greater financial or coverage benefits to either a consumer or a provider? Explain your answers.

HMO- only HMO network of providers, primary care doctor manages care and a referral is required. NO payment for out of network non emergency service. Pre authorization is needed. Low Co payment, limited provider network, covers preventive care.  

PPO- Both out an in network providers. To referrals for specialists, fees are discounted, and preauthorization for some procedures. Higher cost for out of net work providers and preventive care varies.

POS- Both out an in network providers. Must stay within network and primary care doctors manages care. Lower cost of in net work providers and higher for out of net work providers. And also covers preventive care.

Consumer-driven health care plan- Similar to a PPO, Patient pays out of pocket till the deducible is met. High deductible and low premium.

Indemnity plan- You can go to any provider, it’s a higher cost, deducible, coinsurance, and preventive care isn’t usually covered.  

Based on what I understand I think that the PPO is the best way to go. It’s a smaller out of pocket monthly fee and you have a co payment when you go to the doctor, the co payment is usually $20 for in network and $40 for out of network. You can use any doctor or hospital of your choice and if you choose one on the list it is then cheaper. If your younger and you don’t go to the doctor all the time but still need the insurance I think is the best way to go without over paying. Choosing your health plan really depends on if you go to the doctors a lot of if you want to pay a low or high co payment or more out of pocket during the month.