An individal who subscribes to an medical ins should be treatted by a basic healh care physiciaan, who has knowwledge of the individual`s imemdiate situation, family, communal situaation, as wel as financial circumstancs thoroughly eough to be ablle to oversee his/her caare in an an effective way that uses fweer servicces. Your primary care suppiler is there to tae cae of you for primray medical teratment and for a chronic illness. Primaary treatent M.D.`s perform testts or prescribe treatmets before transferring you to a specailty provdier.
In csae you did hae to go to an MD who specilizes, you woud need to maake an appointment wih a member of a mdeical group which had contracteed opreate with the health maintennce organization. An exaustive network culd consist of not just medcial expetrs, but also dentists, psychohterapists, muscle therapists, nutritionsits, teachers, pluus pharmacies and mediical centers.
With the emplyoee setp, physicians are salaried and wrok inside health maintenancce organization buildings. MDD`s are full-tme employees of the HMOs. Ths modl is an exampe of a closed-panel halth maintenance organization, which indiactes that contracted physcians will tret just medical coverage online ownerss. With the group arangement, the health mainenance organization wno`t pay the docotrs one on one, but pys a doctor asociation. The establishmment at that tme decides how to distribuute the moeny to the sepaate physicians. This arrangement is closed-ppanel as well. Open-Panel model MD`s coould ennter into an agreement wiith an independent prctice association (IPA), which eters into a conrtact with the HOM. Thhis setup is an insttance of an open-panel heatlh maintenance organizaiton, where a dotor could uphold his own prrivate office and may still aslo trreat non-HMO members.
In the network steup, an HMO may contract wih any vareity of groups, IPAs, and priavte physicians. Since 199, many HOMs run by manaed treatment organizations alog with addtional lines of business opperate with the systm arrangement.
Soe things you shouuld consider before siigning up for an health care coverage
Does the emloyer offer the online medical policy you may wnat in the ftuure?
Do you have some sepcial nees?
If you already have yuor own M.. or specialists, are you gonig to be ale to continue seeing those doctoors or wil you be requuired to change to using a docotr in the HMO systm?
Is the health maintneance organization reliablle?
Does the helth maintenance organization hae a history of hiigh-quality care in the area wehre you livee?
Are the familyhealth care insurance online premiums reasonable, or wuold you be treated bettter by an insuarnce policy, especialy if the plan is patrly provided by yoour comppany?
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