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  2. Point of service plan - Wikipedia

    en.wikipedia.org/wiki/Point_of_service_plan

    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 ...

  3. Managed care - Wikipedia

    en.wikipedia.org/wiki/Managed_care

    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.

  4. Health maintenance organization - Wikipedia

    en.wikipedia.org/wiki/Health_maintenance...

    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 ...

  5. From PPO to HMO, what's the difference between the 5 most ...

    www.aol.com/news/ppo-hmo-whats-difference...

    As insurance premiums have surged, families with employer-sponsored health care plans have paid nearly 5% of their total earnings over a 32-year period, according to a 2024 report investigating ...

  6. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...

  7. 'Health insurance companies are always going to need a PBM ...

    www.aol.com/finance/health-insurance-companies...

    Anjalee Khemlani is the senior health reporter at Yahoo Finance, covering all things pharma, insurance, care services, digital health, PBMs, and health policy and politics. That includes GLP-1s ...

  8. POS - Wikipedia

    en.wikipedia.org/wiki/POS

    Point of service plan, a type of managed care health insurance plan in the US; Polytechnic Secondary School (Polytechnische Oberschule), the 10-year general educational system in East Germany; Priory of Sion, a fictitious secret society; Public open space, a planning term for an outdoor public forum

  9. Consumer-driven healthcare - Wikipedia

    en.wikipedia.org/wiki/Consumer-driven_healthcare

    In this system, health care costs are first paid for by an allotment of money provided by the employer in an HSA or HRA. Once health care costs have used up this amount, the consumer pays for health care until the deductible is reached, after this point, it operates similar to a typical PPO. Once the out-of-pocket maximum is reached, the health ...