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First down option: a group / an individual

3. Private health insurance - Comparison of plans and providers Aa Aa E In the United States, private health insurance plans can be written as group or individual plans, or as indemnity or managed care plans. Comparing Private Insurance Plans Patricia is able to secure health insurance because she is a member of her credit union. This is an example of insurance plan. Indemnity, or fee-for-service, plans and managed care plans cover medical expenses if you are sick or injured, but in different ways. The following questions examine the general differences between the two plans. Taking a closer look at how these plans provide coverage will help you begin to customize a health care plan that best suits your requirements. Select the plan that most closely matches each given description. Indemnity plan Managed care plan The insurer pays the care provider or reimburses the patient for covered expenses once the deductible has been met An annual deductible is incurred Insureds create contract with, and make monthly payments, to the care provider Service providers must meet specific selection standards A HMO plan is a one example Now that you've taken a closer look at the differences between these types of plans, consider the following statements. Each indicates common preferences and situations. Select the type of plan to which each statement most closely aligns. Indemnity plan Managed care plan I most value the freedom of choice and am willing to pay for it. Cost is my most important consideration. I'd rather have the flexibility of either having the insurance company reimburse me or directly paying the health care provider. There are several types of managed care plans, including group health maintenance organizations (group HMOs), individual practice associations HMO (IPA HMOs) preferred provider organizations (PPOs), exclusive provider organizations (EPOs), and point-of-service (POS) plans. Deciding which particular type of practice would best meet your needs requires knowing the major characteristics of each. Therefore, identify the particular form of private health care organization or plan described by the following three clues: Clue #1: I'll see all of the doctors and medical professionals in my plan by visiting them at a central facility. Clue #2: To receive the covered medical services, I'll pay a monthly fee and a small copay for each visit to the doctor or prescription. Clue#3: Many of these plans now allow me to obtain medical services from doctors or facilities located outside my plan's geographic area. If I want my plan to exhibit these characteristics, then I should purchase: O a Blue Cross/Blue Shield plan O an IPA HMO O an EPO O a group HMO