Three Main Types of Health Insurance in the US - Assignment Example

The health savings accounts on the other hand provide patients under this plan the ability to save their money to afford future medical expenses they may incur. These savings are usually tax-free for people to afford them. This insurance policy is suitable for individuals in the lower social class and provides them an opportunity to enjoy medical benefits from the government.
Three methods for categorizing health insurance in the U.S.
The first method of categorizing is based on the illness of the individual. These include disability benefits, insurance for long-term illnesses, and even for the aged. The second category is based on the organization sponsoring the insurance coverage. The prestigious organizations have many areas to cover and hence are more expensive.

The selection of the insurance firm will therefore depend on the social class of an individual. The third categorization is dependent on the funding mechanism. This is the funding to the insurance organization by other organizations or the government. The most funded insurance firms charge fewer costs to their clients hence most people prefer them (Ulmer et al 2010).
The three types of managed care plans provide the pros and cons of each for the health care provider, insurer, and patient.
The first type of managed care plan is the Health Maintenance Organization (HMO). The advantage is that the patient gets to choose the physician to treat him or her (primary care physician). This way, the doctor knows the patient and all their problems and hence can treat them better than if it was a new patient whose medical history he or she is not familiar with. The plan is advantageous also to the insurer as the costs of the premiums are shared among all the members. The disadvantage of this plan is that in case, of an emergency, the patient may suffer because they have a primary care physician who examines them and not any other, this is deemed as a waste of time and risky to the patient’s health (Kongstvedt 2007).

The other type of managed care plan is the Preferred Provider Organization (PPO). They are advantageous to the patient in that they pay less for health services due to the cost-sharing with the hospitals and health care providers. This also proves to be an advantage to the insurer as they will incur less cost. It is similar to the HMO in that the doctor treats their patient whom they get to know well. However, this plan attracts more patients due to the low prices and hence becomes unmanageable to the doctors as they are overworked.
The third managed care plan is the Point of Service Plan (POS). The advantage of this plan is that the patients can choose even doctors and physicians from other networks other than the ones provided in the scheme. This proves to be an advantage to the doctors too as the burden of having to attend to many patients is reduced. The insurer also benefits by having many individuals choose this plan due to its flexibility. The disadvantage is that an individual requiring out-of-network services has to reach a certain amount of deductibles first which is around $300 per year per individual.
The impact of managed care on both the Medicare and Medicaid programs.
Medicare and Medicaid programs are those health care programs designed for aged individuals and especially those over 65 years. Managed health care helps individuals in these programs by enabling them to pay for both inpatient and outpatient hospital services without having to worry (King 2009). This applies to even those patients with serious diseases whose part of the hospital bill is paid for by the managed care insurance plan. Read More