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Pros And Cons Of Managed Care Organizations

468 Words2 Pages

You have now learned that there are various forms of Managed Care Organizations. As a purchaser of health insurance, which form is more appealing to you? Discuss the pros and cons of your choice.
Please provide specific, referenced examples in your discussion.

HMO’s and PPO’s are typically marketed the most. However, there isn’t the “perfect health plan type”. Each type is just a different balance point between benefits vs restrictions, and between spending a lot vs spending less. I personally like the POP plans, as it seems to allow me a greater ability to select my healthcare provider. Though a POS plan sounds rather attractive.As Davis defines a POS as, “POS stands for point of service plan. POS plans resemble HMOs but are less restrictive in that you’re allowed, under certain circumstances, to get care out-of-network like with a PPO. Like HMOs, many POS plans require you to have a PCP referral for all care whether it’s in or out-of-network (Davis,2016). Therefore, with any healthcare decisions, an individual must look at what their essential healthcare needs are. I like many others question this on a daily basis in regards to my healthcare needs. However, as Davis also indicates that there are 6 preferred basics that we must analyze.
1. …show more content…

Whether or not you’re required to have a primary care physician.
2. Whether or not you’re required to have a referral to see a specialist or get other services.
3. Whether or not you have to have health care services pre-authorized.
4. Whether or not the health plan will pay for the care you get outside of its provider

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