Health Care Finance

1.) What are some advantages and disadvantages of Preferred Provider Organization (PPO), Health Maintenance Organizations (HMOs), COBRA, Medicare, Medicaid and Tricare?

2.) How do you feel about Americans who fall under the category of having "Uncompensated Care?" Do you think the government should do anything about it? If, so what do you think they should do? If not, support your answer.

Full Answer Section

   
  • Disadvantages:
    • PPOs can be more expensive than HMOs.
    • You may have to pay more out of pocket for services that are not covered by your plan.
    • You may have to meet a higher deductible before your insurance company starts paying for your care.
Health Maintenance Organization (HMO)
  • Advantages:
    • HMOs are typically less expensive than PPOs.
    • You may have lower copays and deductibles than with a PPO.
    • You may have access to preventive care services at no cost.
  • Disadvantages:
    • You must choose a primary care physician who will coordinate your care.
    • You may have to get a referral from your primary care physician to see a specialist.
    • You may have to wait longer for appointments than with a PPO.
COBRA
  • Advantages:
    • COBRA allows you to continue your health insurance coverage after you lose your job.
    • You pay the full premium for your coverage, but your employer may subsidize some of the cost.
  • Disadvantages:
    • COBRA is expensive.
    • You can only keep your coverage for 18 months or 36 months, depending on your situation.
Medicare
  • Advantages:
    • Medicare is a federal health insurance program for people 65 years of age and older, as well as people with certain disabilities.
    • Medicare covers a wide range of services, including doctor visits, hospital stays, prescription drugs, and preventive care.
    • Medicare is generally more affordable than private health insurance.
  • Disadvantages:
    • Medicare does not cover all services, and you may have to pay out of pocket for some things.
    • Medicare can be complicated to understand, and there are many different parts to the program.
Medicaid
  • Advantages:
    • Medicaid is a government health insurance program for low-income people, pregnant women, children, and people with disabilities.
    • Medicaid covers a wide range of services, including doctor visits, hospital stays, prescription drugs, and preventive care.
    • Medicaid is generally free or very low-cost for eligible people.
  • Disadvantages:
    • Medicaid can be complicated to qualify for, and the eligibility requirements vary from state to state.
    • Medicaid can be difficult to get approved for, and there are many different rules and regulations to follow.
Tricare
  • Advantages:
    • Tricare is a health insurance program for active-duty military members, their families, and retirees.
    • Tricare covers a wide range of services, including doctor visits, hospital stays, prescription drugs, and preventive care.
    • Tricare is generally free or very low-cost for eligible people.
  • Disadvantages:
    • Tricare can be complicated to understand, and there are many different parts to the program.
    • Tricare can be difficult to get approved for, and there are many different rules and regulations to follow.
The best health insurance plan for you will depend on your individual needs and circumstances. It is important to compare different plans and talk to your doctor to find the best fit for you.  

Sample Answer

   

Preferred Provider Organization (PPO)

  • Advantages:
    • PPOs offer more flexibility than HMOs, as you can see any doctor in the network, even if they are not your primary care physician.
    • You typically have lower copays and deductibles than with an HMO.
    • You can usually get your care faster than with an HMO, as there are no referrals required.