The current health care system in the United States has changed from managed care to health care management. Its center of gravity has gradually tilted from merely caring for the patient to caring for the health of the entire population. In recent years, health insurance has not only served the insured, but has also provided information, technology and access to the latest scientific and technological information to medical practitioners through its comprehensive and integrated services. Effective health plans encourage patients to get tested; personalized treatment plans are designed for the chronically ill like never before; doctors are provided with the latest treatments; and the health care system is unmatched in its ability to analyze information, manage finances, and satisfy the rising
information needs of hospitals and medical staff and to assist them in making the best possible treatment plans.
The new system has achieved tangible results in the shift away from the previous lump sum health insurance and reactive medical compensation programs, which were difficult to monitor. This can be seen in several ways:
First, ****together with participation is an indispensable element for the smooth running of the insurance program. Doctors are able to make clinical decisions more effectively; and participants are more aware of how the program works and how they can benefit from it.
There are three broad types of health insurance in the United States:
1) Government insurance: the government, through the Public Health Service (PUBLIC HEALTH
SERVICE), including health care institutions (e.g., hospitals, medical colleges and universities) and research institutes;
The Department of Social Security Services (DSS), which administers the MEDICARE and MEDICAID programs, implements the MEDICARE and MEDICAID programs. The Department of Social Insurance Services, which implements the MEDICARE and MEDICAID programs
Medicare programs
2) Commercial insurance: These are general insurance companies
3) The business owner pays the majority of the cost, and the insured individual pays the rest of the cost accordingly
There are many different types of health plans in existence, but choosing the most suitable plan for you is the most important
important thing.
The famous Blue Cross and Blue Shield insurance company uses a questionnaire to help its customers make their choice:
The questions are as follows (each question is worth 1, 2 or 3 points depending on whether it is a yes, a neutral or a no question):
1) Do you travel a lot? Would you like an insurance plan to ensure your safety and that of your family when you go
away from home, e.g., to college, on long trips, etc.?
2) Have you been sick before?
3) Is it important to you to be able to use a particular prescription drug?
4) Do you think it is important to be able to get access to specialists without a referral from your doctor
5) Would you prefer to choose your own doctor or hospital, but it may cost more
6) Would you like to be able to be provided with a plan for your daily and preventive care
7) Would you like to be able to cover the most of your medical expenses
Are you willing to change your family doctor to save money?
Clients can choose the right insurance plan based on the score they get on the questions
Score: 8-11 can choose HMO health insurance
Score: 12-16 can choose POS health insurance
Score: 17-20 can choose PPO health insurance
Score: 21-24 can choose one-time payment health insurance
What is a PPO
[Preferred Provider Organizations] (PPOs) are health insurance plans that offer discounts on medical expenses exclusively for members. Members must go to a designated provider who may or may not be a member of the PPO network.
What is an HMO
HMO stands for Health Maintenance
Organization that specializes in providing financial risk and delivery risk for volunteers who provide health care in special areas, usually for a fixed return, at a prepaid cost.
What is POS
The full name of POS, Point-of-service, allows members the freedom to choose their own provider, i.e., any provider within or outside the organization's network.
What is a healthcare provider
A healthcare provider is an organization or individual such as a hospital, medical facility, doctor or other healthcare worker who can provide healthcare services.
What is a PCP (PRIMARY CARE PHYSICAN)
A PCP is the initial and primary provider of services in a health insurance plan, such as a doctor or medical professional, also known as a PERSONAL CARE PHYSICAN or PERSONAL CARE
PROVIDER
In general, a provider is an organization or individual that provides health care services such as hospitals, medical equipment, or other medical workers. p>
In general, the implementation of the health care system is a rigorous "referral system" consisting of PCPs to state-of-the-art treatment programs and a monitoring process by evaluation bodies called "gate-keepers". It is incumbent on health economists to do more to reduce spending, redirect resources, and ensure that Medicare grows.