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Health Insurance Basic

Loss of Income from Disability
Accidental Death & Dismemberment
Medical Expense Benefits
Dental Expense Benefits
Medical Expense Insurance
Long-Term Care Insurance (LTC)
Limited Health Exposures
Prescription Coverage
Determining Insurance Needs
Health Care Providers
Health Care Plans
Health Care Commercial Insurers
Health Maintenance Organizations
HMOs -Federal Requirements
HMO Organization
HMO Exclusions
Basic and Supplemental Services
HMO Co-Payments
Important Features Of HMOs
HMO Complaints
HMO Quality Assurance
   

Health Care Providers
Patients have traditionally been seen by physicians in office or hospital environments. Today physicians also see patients in a variety of settings including the following:

  • Surgicenters provide a site for outpatient surgery where general anesthesia must be used, but a patient does not need to stay overnight.
  • Urgent care centers see patients often without an appointment during the daytime, as well as evening and weekend hours.
  • Skilled nursing facilities provide medical care for patients who no longer require hospitalization but cannot yet care for themselves at home.
  • Home health care is also provided by nurses and others for patients ready to be at home but who cannot yet fully provide for all of their own needs.

The traditional broad health coverage provided by insurance plans provides little incentive for efficient, cost-effective health care delivery. Managed care imposes controls on the use of health care services, the providers of health care services, and the amount charged for these services, usually through health maintenance organizations (HMOs) or preferred provider organizations (PPOs).

 

 

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