Lesson 6 Discussion with students
. Responding to two of your peers’ posts
1st students response
Indemnity is a type of insurance policy where the insurance company guarantees compensation for losses or damages sustained by a policy policyholder. Medical malpractice and errors and omission insurance are examples of indemnity insurance.
Managed care became mainstream, since it controls costs better than an indemnity plan does. Medical coverage and conveyance of medical services are joined into a single system.
The three main types of managed care are health maintenance organization, preferred provider organization, and point of service.
HMO pros are, it’s the least expensive form of managed medical care. In HMO individuals pay a fixed premium (monthly fee). A list of doctors is provided so you can choose your primary care doctor, your primary care physician will referrals you to a different specialist if needed.
Some HMO cons are no out-of-network benefits. You must see physicians, specialist, labs, and testing at you capitated site.
PPO pros are, generally cover expenses if an individual wants care outside of their network but at a smaller percentage. You can choose your primary care physician. Also, you can choose your specialist.
Some PPO cons are, out of network visit usually requires a deductible. PPO is very expensive.
Pos pros are usually have limited choice but offer lower cost. No deductibles. Primary care physicians can refer the individual outside of the network, but with limited coverage.
Pos cons, internet issues in connectivity. High cost.
2nd students reponse
What is the definition of “indemnity” insurance? The indemnity insurance definition is known as a type of insurance policy that allows you to choose your own doctor, specialist, and this includes a hospital for all your health care services. With the indemnity plan you have more freedom on who you see and where you go.
Why do you suppose it has largely been replaced by managed care? I suppose it has largely been replaced by managed care plans because of cost and quality. Managed care plans have there own providers and facilities on where you can go. They somewhat dictate where you go and who you see.
What are the three main types of managed care organizations? The three well-known types of managed care organizations are The Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Point of Service Plan (POS), and here is a fourth Exclusive Provider Organization (EPO).
What are the pros and cons of each type? The indemnity plan pros is that you have the freedom to choose where you want to go for healthcare and who you want to see and I don't see a con for this. Managed care plan has a lower cost as a pro if you go to the place that is in network, the con of this is that they state where you can go for coverage.