Prepaid Models In Health Care

There are many different models of insurance for health care services. All of theses models are based off fee-for-service or prepaid models, which are two different types of payments. Fee-for-service models are a more personalized type of plan that allows the individual to pay only for the coverage that they will utilize (Buchbinder & Shanks, 2017). Fee-for-service organizations charge a specified amount for each service rendered and are paid that amount in full by the patient or by a copay and insurance reimbursement. This is very different from prepaid models in which the organization has a contracted arrangement through a retainer, salary, or some other arrangement ( Marcinko, 2006). Prepaid models ,as defined by Marckino, are "A

In the prepaid model, most services are covered completely with an occasional copay for certain services (Buchbinder & Shanks, 2014). This allows the individual to obtain medical treatment at any time without worrying about out of pocket expenses. While the fee-for-service model typically requires a patient to reach a deductible before their insurance kicks in (Buchbinder & Shanks, 2017). This could cause the individual to have a lot of out-of-pocket expenses, or it could save them a lot of money. An individual in great health that rarely sees a doctor, will save money because they would potentially only spend a small amount or nothing at

In my opinion, Comprehensive Indemnity plans are the best for the consumer. I have TRICARE prime and a comprehensive insurance plan, but I choose to use my comprehensive insurance. Comprehensive plans allow you the freedom to choose your care facility. This freedom maintains consumers abilities to receive excellent care because otherwise you are free to find a new facility. TRICARE utilizes an HMO model in which the consumers care facility and physician is chosen for them. If the consumer receives bad care, then they must go through a process to change providers and can only change to another provider within the HMO. This takes away the power of the consumer. It is important that a patient has control over who they are seeing, or else there is no pressure on the facility to maintain quality care. HMO's are paid the same amount no matter the quality of amount of care they provide (Buchbinder & Shanks, 2017). This is yet another reason why comprehensive plans are better. There is no competition for an HMO; Therefore, they have no pressure to satisfy their patients. Essentially they know that patients cannot see anyone else, so if you cant leave then why go above and beyond? In my experience, this mediocre care has been all i've received. Comprehensive insurance is better because it is worth