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Free Features of Private Payers Essay Sample

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Private payer plans such as PPOs, HMOs, and Group HMOs are very popular in making decisions related to health coverage. But there are IPAs, POSs, and Indemnity plans also to be considered while making decisions on health coverage. The Consumer driven health plans accounts are made "for the consumer" and therefore consumers who are the patients have the choice to choose which plan to opt. Sometimes consumers can build their own health plan according to their financial situations with savings account options. After having an idea about this, the reader will have a clearer idea of the options available through health care coverage. Preferred provider organizations (PPOs) are based on membership to a specific health care provisions arrangement. PPO's are discounted fee-paid services. The provider of PPO provides services that are guided by discounts.


The HMO was set up by the US government in 1970s is to provide health services where there is a need. Health maintenance organizations (HMOs) are state licensed and therefore are a lower cost health plan. HMO's are of two different types. HMOs together bring into a broad range of health services and deliver those services for a fixed, renegotiated fee. They are the prepaid group practice model and the medical care foundation (MCF), also called individual practice association.

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Group HMO is a health maintenance organization (HMO) in which a contract is established with multispecialty medical groups for medical services. The HMO is responsible for marketing and developing contracts with enrollees and hospitals. Care is provided at hospitals where the physicians have admitting privileges or at ancillary facilities with which the HMO subcontracts.

Independent Practice Association is a type of Health Maintenance Organization (HMO) that issues contracts to independent physicians. These physicians are paid a per visit fee for seeing an HMO member or are paid an annual fixed sum. The HMO members are covered only when they use an HMO hospital or physician. POS plans provide the best of both worlds, that's why they are so popular. And when it comes to the indemnity part of POS plans, people find a lot of flexibility and freedom that just can't be obtained through typical managed care options. Just like in the case of PPO plans, you are still able to get insurance coverage even when addressing to a specialist outside of the POS provider network.

CDHP are health benefits plans that are engaged to cover individuals in choosing their own health care providers, managing their own health expenses, and improving their own health with respect to factors that they can control. Health Reimbursement account is an employer-funded plans that pay back  employees for incurred medical expenses that are not covered by the company's standard insurance plan.  The employer funds the plan, any distributions and is considered tax deductible to the employer. Reimbursement dollars received by the employee are generally tax free. Flexible Saving Account is an employer-sponsored benefit that enables to pay the medical expenses on a pre-tax basis. By this one can decrease taxable income and can save thousands of dollars a year.

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