Types of Health Insurance:
1. Indemnity Plan: An indemnity plans is one of the oldest plans for health insurance. They are extremely costly and there are not many still in existence. It is the least restrictive of all health plans out there. A contract is between the individual and the insurance company whereas traditionally the patient would incur a claim at the doctor’s office Wholesale Washington Wizards Jersey , pay the doctor, get a copy of the bill and then submit it to the insurance company. Thus the doctor could charge whatever he wants for the service and in some cases, the insurance company would have to reimburse the patient accordingly. There are no networks or referrals needed. All checks go to the patient.
2. Health Maintenance Organization (HMO): An HMO is the most restrictive type of health coverage. An HMO is a contract between the doctor and the health carrier. In almost all instances there is a network involved, the patient must get referrals Wholesale Utah Jazz Jersey , there is a primary doctor (gate-keeper), and the doctor is paid per head (capitated) whether or not he sees the patient. Benefits are paid only in network providers and no benefits would be paid if the patient goes out of the network. Advantages to the doctor, he gets a set amount of income every month, has an immediate patient client base Wholesale Toronto Raptors Jersey , and the advantage to the patient is typically lower premiums and smaller copays. Other characteristics are the doctor gets a bonus or percentage of patients not referred to specialists. All checks go to the doctor. Other than deductibles, copays, and non-covered services, a collection agency may not collect from the individual patient.
3. Preferred Provider Organization (PPO): A PPO is a plan that allows patients the benefits of a network that does not require referrals and if the patient uses the in-network doctors Wholesale San Antonio Spurs Jersey , he typically has a modest copay and deductible and coverages are richer than if he goes out of network. If the patient goes in-network, typically he does not need a referral thus there is no gate-keeper. If the patient decides to go out of network, he still will have coverage, however the copays and deductibles are higher and the coverages are more restrictive and limited. In both cases Wholesale Sacramento Kings Jersey , in and out of network, the doctor is paid fee for service, thus he has an incentive to see the patient and in-network payments from the health insurance carrier is paid directly to the doctor. This plan is less expensive than the indemnity plan but more expensive than the HMO. The advantage of a network for the doctor is the doctor gets the check mailed directly to him and patients are more likely to use a doctor in their network. The advantage to the health insurance carrier is they have a pre-determined negotiated in-network fee that is typically much less than a out of network, non-negotiated fee.
4. Point of Service (POS): A POS is a hybrid plan that in-network acts like an HMO (capitated) Wholesale Portland Trail Blazers Jersey , requires referrals in-network, has gate-keepers, etc. but allows the flexibility for the patient to go out of network. Out of network claims have higher deductibles and copays and limited and more restrictive coverage of services. In network, the check goes directly to the doctor; out of network Wholesale Phoenix Suns Jersey , checks go to the patient. Since it has an out of network component, it is not considered an HMO thus is classified as an insurance plan in or out of network and you can pursue the patient (in or out of network). This plan is less costly than a PPO but typically more expensive than an HMO.
5. Self-Funded Health Plans: You may not come across too many of these. These are typically union plans or large single employer plans. They typically fund their own losses up to $200,000 and have re-insurance or stop loss above that amount. They write their own plan documents and are governed by the Department of Labor under the TaftHartley Act and pre-empt state jurisdiction in most cases.
David Weinstein of Cherry Hill, NJ is an accomplished business man who is in the process of writingpublishing a book devoted to the clarification of new rules and regulations as well as compliance for the healthcare professions as well as the general public.
Shopping for New Clothes After Liposuction Health Articles | January 24 Wholesale Philadelphia 76ers Jersey , 2012After losing weight and having liposuction performed, you will likely need to shop for new clothes. Here are a couple of things to remember as you head out to the mall.
Liposuction (lipo) is the removal of body fat by using suction. Typically,
this procedure is performed under anesthesia after a person has come close to
their goal weight but is unable to make stubborn fat move. Liposuction is the
process of sculpting the body so that desired results are achieved. Once the
procedure is completed and you are completely healed, chances are good that you
will need to go shopping for some new clothes!
Obviously Wholesale
Orlando Magic Jersey , the area where you have lipo will determine
what kind of clothes you need to replace. Did you have liposuction on your arms
or neck? You need some new tops! Did you have the procedure done on your thighs?
Then you are going to need some new jeans and shorts! Shopping will be much
different than before. Clothes are going to fit completely differently after you
have recovered from surgery than they did before. Make sure that you are fully
healed and that the swelling has completely diminished before attempting to add
to your wardrobe.
If you lost a lot of weight, you will likely find
yourself shopping in a completely different department of the store than before.
You may even be able to shop in different stores altogether. If you are unsure
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