There are multiple choices of what health insurance plan to select based on what a person is looking for whether it is a single policy or family plan. Insurance assists to protect a person from high healthcare costs, particularly those associated with medical conditions or the need for hospitalization. There are two types of health cover policies, including managed care and fee-for-service plans. Health Maintenance Organizations (HMO), Point-of-service Plans (POS), and Preferred Provider Organizations (PPO) are varied forms of managed care policies. key factors, such as household income and cost will help an individual illuminate what plan is right for them or the business , and keeps them focused while they are making decisions. Health insurance costs and income are two key factors to consider when it comes to choosing the best health insurance coverage. Private hospitals can be pricey, so it is essential to know how much money an individual can afford to spend on health insurance each month. Due to increases in deductibles and the advent of high-deductible health plans, most organizations have started to offer their employees the chance to fund their healthcare expenses through a health savings account. These accounts with special tax treatments intended to assist workers’ pay for health insurance. Therefore, this means that if the deductibles are included, the company will pay each time the employee visits a health facility for a checkup or the costs of prescription medications required for treatment. While some people receive insurance via the employers, many unemployed and low-income individuals do not have access to group coverage (O’Brien, 2003).
Additionally, private insurance premiums might be pricey, making individual coverage out of reach for most. Whatever the reason, not having health insurance might have costly and at times acute outcomes. By contrast, having health care plan offers individuals the chance to continue living healthier lives by providing an inexpensive way to attend doctor checkups and purchasing low-cost prescription drugs.
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Choosing a health insurance policy can be an arduous and confusing process for many organizations. Business leaders have to look at a wide range of plans, providers and coverage options, and circumnavigating them might prove to be difficult. In regards to choosing a policy cover for my organizations, I am not sure which is the best, as each has a downside to it. Many companies can allow employees to pick their health cover policy. Other organizations provide only one plan. Some insurance policies provide full coverage including dental, vision, and medical. Therefore, if I had to pick a health care policy for my firm, I would select PPO. PPO stands for Preferred-Provider Organization.
According to Borelli, Bujanda, & Maier (2016), PPO is offered by private insurance companies. In PPO, the person pays less if he or she uses physicians, hospitals, and other healthcare caregivers that belong to the policy’s network. Since PPOs have become the predominant paradigm of managed healthcare in the private sector, legislators have progressively perceived the PPO plan as an attractive choice for Medicare. PPO is developed by chartered measures between a financial broker and a system of healthcare benefactors (Borelli, Bujanda, & Maier, 2016). Different from the established HMO model, the PPO plans offer each enrollee insurance similar to indemnity cover, employing monetary incentives as opposed to stringent provider access limits, to channel care to network providers.
However, Borelli, Bujanda, & Maier comments that (2016). Since PPO plans, like HMO policies, have a provider network, a PPO has a higher potential for cost control that fee-for-service plans (Borelli, Bujanda, & Maier, 2016). Traditional PPOs can also employ other managed care approaches, including caregiver profiling, monetary and non-monetary benefits, and powerful controlling systems to maintain efficacy and excellent care delivery.
Because that the Affordable Care Act (ACA) has made its presence known, it is assisted me in deciding the type of healthcare plan I would like to buy for my company (Andrews, 2018). Today, everyone is still expected to have health insurance that adheres to the minimum coverage standards lay down by the ACA. This implies a policy that integrates an exhaustive set of benefits and covers at least two-thirds of an individual’s medical costs. This is the reason which made me purchase health care plan, as the law dictates that failing to have insurance, there is a hefty fine associated to be imposed unless one qualifies for an exemption (Andrews, 2018). For 2018, the fee is the greater of $695 or 2.5% of household income (Andrews, 2018). One advantage of purchasing health insurance policy for my employees is that the business will get tax advantage of deducting cover contributions. Another advantage is that purchasing a health insurance policy makes economic sense. Another advantage is that providing health insurance has proved to alleviate absenteeism and better employee health, wellbeing and morale (O’Brien, 2003). However, providing health insurance benefits generates worries concerning legal agreement that in succession engenders the organization to suffer legal fees. Besides, the more incentives an organization offers, the more it should pay out-of-pocket for organizational expenses.
In conclusion, it is vital for everyone to have some healthcare cover even if is it provided by the employer or government coverage. In one sense, purchasing health insurance is not an easy task. Quality can mean many things for health policy, and the criteria used differ from one person to another. The healthcare program and quick treatment are one of the best ways to prevent sickness. Therefore, offering the employee healthcare benefits gives them a peace of mind knowing that they are entitled to health insurance and capable of living overall healthier lives. While premiums might be pricey and many individuals fail to see the reason to purchase something they seldom use, and it is a significant risk not to have some health coverage.
References
Andrews, M. (2018, 24 April). 4 New Exemptions to The Tax Penalty for Lacking Health Insurance. NPR . Retrieved from https://www.npr.org/sections/health- shots/2018/04/24/605007498/4-new-exemptions-to-the-tax-penalty-for-lacking- health-insurance
Borelli, M.C., Bujanda, M., & Maier, K. (2016). “The Affordable Care Act Insurance Reforms: Where Are We Now, and What’s Next?” Clinical Diabetes , 34(1), 58-64.
O’Brien, E. (2003). “Employers’ Benefits from Workers Health Insurance.” Milbank Quarterly , 81(1), 5-43.
