Health insurance is an essential medical document that an individual in the US must have to obtain easy and affordable access to health care services when needed. I have chosen an insurance plan with United Health Care, which allows me to spend less on my medical procedures. The insurance plan helps significantly in terms of the fixed payments I must make once I receive a service, and coverage of the costs by the insurance company ensures my financial confidence.
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Overall, the US health insurance system contains multiple organizations that work to reduce the burden of the increasing costs of health services in the country. The two options Americans have are health maintenance organizations (HMOs) and preferred provider organizations (PPOs), which have similarities and differences in the way they manage the cases of their clients and the premium costs they require. According to Dafny et al. (2017), such organizations are significantly different in-hospital network breadth, which defines the costs of the services. Indeed, both HMOs and PPOs cooperate with health care providers to facilitate patient outcomes for the insured clients. The reduced costs for the population significantly benefit the users of the insurance since their health care expenditures are partially covered. Thus, they do not suffer from the increase in the prices for medical procedures.
Overall, the significant advantage of HMOs is a low premium cost, which is justified by a limited choice of hospitals and doctors one is referred to by their physician. Thus, the fewer options of specialists and facilities is a disadvantage of HMOs. On the contrary, PPOs, provide complete freedom for a client to choose their preferred specialist of the facility, which is an advantage. However, such freedom and breadth of networks imply higher premium costs for the applicants. Therefore, it is necessary to define the most influential factors for insurance choice before selecting a type of insurance organization.
Dafny, L. S., Hendel, I., Marone, V., & Ody, C. (2017). Narrow networks on the health insurance marketplaces: Prevalence, pricing, and the cost of network breadth. Health Affairs, 36(9), 1606-1614.