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INSURANCE & COSTS HEALTH CARE SERVICES. MEDICAL CARE (INSURANCE) HEALTH MAINTANCE ORGANIZATION (HMO) – A TYPE OF GROUP HEALTH INSURANCE PLAN – MEDICAL.

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Presentation on theme: "INSURANCE & COSTS HEALTH CARE SERVICES. MEDICAL CARE (INSURANCE) HEALTH MAINTANCE ORGANIZATION (HMO) – A TYPE OF GROUP HEALTH INSURANCE PLAN – MEDICAL."— Presentation transcript:

1 INSURANCE & COSTS HEALTH CARE SERVICES

2 MEDICAL CARE (INSURANCE) HEALTH MAINTANCE ORGANIZATION (HMO) – A TYPE OF GROUP HEALTH INSURANCE PLAN – MEDICAL NEEDS MET THROUGH A SET OF DESIGNATED DOCTORS – ‘PRIMARY CARE PHYSICIAN’ – MONTHLY PREMIUM / FEW OR NO OUT-OF- POCKET EXPENSES

3 MEDICAL CARE (INSURANCE) PREFERRED PROVIDER ORGANIZATION (PPO) – A TYPE OF HEALTH INSURANCE PLAN – DESIGNED BY INSURANCE COMPANIES – MEDICAL NEEDS MET THROUGH ANY DOCTOR AVAILABLE – CHARGE PEOPLE LESS THAN USUAL FEES FOR DOCTORS WITHIN THE PROGRAM – CAN CHOOSE DOCTOR OUTSIDE OF PLAN – COSTS MORE – MONTHLY PREMIUM / CAN CHOOSE DOCTOR IN PLAN OR ONE OUTSIDE OF PLAN

4 MEDICAL CARE (TERMS) PRIMARY CARE PHYSICIAN – MEDICAL DOCTOR WHO PROVIDES PHYSICAL AND CHECKUPS / GENERAL CARE SPECIALISTS – MEDICAL DOCTORS TRAINED TO HANDLE PARTICULAR KINDS OF PATIENTS OR MEDICAL CONDITIONS

5 MEDICAL CARE (INSURANCE) MEDICAID – PUBLIC HEALTH INSURANCE THAT PAYS FOR HEALTH CARE FOR PEOPLE ON WELFARE – PREMIUMS PAID FOR BY THE GOVERNMENT ONLY – 30 BILLION PER YEAR

6 MEDICAL CARE (INSURANCE) MEDICARE – PUBLIC HEALTH INSURANCE FOR PEOPLE 65 OR OLDER AND THOSE WHO RECEIVE SOCIAL SECURITY – VOLUNTARY ENROLLMENT – PREMIUMS SHARED EQUALLY BY PEOPLE AND GOVERNMENT – 45 BILLION PER YEAR

7 MEDICAL CARE (INSURANCE) MAJOR MEDICAL – DESIGNED TO GIVE LARGE AMOUNTS FOR MAJOR EXPENSES – NOT SMALL OUT OF POCKET EXPENSES COMPREHENSIVE – BASIC MEDICAL CARE PLUS MAJOR MEDICAL COVERAGE INCOME (DISABILITY) – BENEFITS WHEN ACCIDENTS OR SERIOUS ILLNESS OCCURS

8 MEDICAL CARE (SERVICES) COSTS – ON AVERAGE OVER 125% MORE THAN 10 YEARS AGO – REASONS: CONSTRUCTION COSTS HOSPITAL EMPLOYEE SALARIES EQUIPMENT BECOMES OBSOLETE & UNUSUABLE MALPRACTICE INSURANCE

9 MEDICAL CARE (SERVICES) FACILITIES – PRIVATE PRACTICES – CLINICS – GROUP PRACTICES – HOSPITALS – EMERGENCY ROOMS – URGENT CARE CENTERS


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