Health Insurance Vs Private Health Care

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Meeting the health needs of the citizenry is complex, tedious and expensive, most of the times, requiring millions of dollars for implementation of health care services, policies and programs. Health care economics is the lifeline of health care delivery. The greater the demand for health care services, the greater the need for available and adequate funding. And as such, the intricacies of health care financing displayed a remarkable degree of continuity from the days of ancient civilization until the current 21st century. Developments in medical science and technology led to critical reflection on the outsourcing of finances vital to health care. In order to maintain a delicate balance between health expenditures and the quality of patient…show more content…
An insurance is a financing mechanism that aims protection against risk. If placed within the context and scope of health care, risk means the potential economic loss incurred by health consumers as a result of illness, accident or death. Therefore, health insurance is the financial mechanism through which people at risk of illness, accident or death can avail of health care services. Health insurance is the type of insurance that covers protection against the costs of medical services, disability or long-term care.The health insurance industry in the U.S is primarily pluralistic with many key players involved. Primarily, there are two types of health insurance: private health insurance and public (government) health insurance. The funding for most health insurance comes primarily from employers and the government. , Meanwhile, private health insurance is mainly voluntary and involves various health plan providers. (Liu & Singh,2008).

In lieu of this, health insurance manifests the following key concepts: First, there must be an "insured or beneficiary". A person protected under a particular health plan against substantial loss secondary to illness or death is known as the insured. The two classifications of employer-sponsored plans are single coverage plans and family coverage plans. In single coverage plans, only the employed individual is covered by the health insurance plan. While, family coverage plans provide protection not only to
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A health consumer who wishes to avail of a health insurance plan must take into consideration all of the above-mentioned general concepts. Furthermore, an individual can only make a sound decision and judgment if he knows which is the best health plan suited for him and his family. So, what are the different types of private health insurance?There are five private health care plans in the U.S.: managed care plans, indemnity plans, health maintenance organizations, preferred provider organization plans, and point of service plans. How does one differentiate each types of private health insurance plans?

Managed care plans have contract with designated health care providers and health facilities, who in turn provide health services at a discounted rate. The designated health care providers are part of the insurance company 's network and usually have guidance rules which speficy how much of the health care cost will the plan reimburse or pay for.
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