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A point of service plan is a type of managed care health insurance plan in the United States. It combines characteristics of the health maintenance organization (HMO) and the preferred provider organization (PPO). [1] The POS is based on a managed care foundation—lower medical costs in exchange for more limited choice. But POS health ...
An Exclusive Provider Organization plan, like a POS, combines different facets of basic HMO and PPO plans. Unlike POS and HMO plans, however, EPOs allow you to choose your own PCP and see ...
A POS plan uses some of the features of each of the above plans. Members of a POS plan do not make a choice about which system to use until the service is being used. In terms of using such a plan, a POS plan has levels of progressively higher patient financial participation, as the patient moves away from the more managed features of the plan.
In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. [1] It is an organization that provides or arranges managed care for health insurance , self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care ...
The Affordable Care Act has had huge ramifications on self-funded health plans; market reforms have invalidated many plan designs that were previously used, and now that employees are required to have health insurance and many employers are required to offer health benefits as well, [3] the self-funded industry has enlarged.
The Kaiser Family Foundation studied how consumer-driven health plans cover pregnancy. They found wide variations in cost sharing. Pregnant women could face exposure to high out-of-pocket costs under consumer-driven health plans, particularly when complications arise.
Tufts Health Plan was a Massachusetts-based non-profit health insurance company under Tufts Associated Health Plans, Inc. with headquarters in Watertown, Massachusetts. [1] It completed a merger with Harvard Pilgrim Health Care on January 1, 2021, making the then unnamed company the second-largest health insurer in Massachusetts.
Health reimbursement account (HRA) Health savings account (HSA) High-deductible health plan (HDHP) Medical savings account (MSA) Private Fee-For-Service (PFFS) Health insurance in the United States. Health insurance marketplaces; Premium tax credit; Managed care (CCP) Exclusive provider organization (EPO) Health maintenance organization (HMO)