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e. 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 ...
Overview. A preferred provider organization is a subscription-based medical care arrangement. [1] A membership allows a substantial discount below the regularly charged rates of the designated professionals partnered with the organization. Preferred provider organizations themselves earn money by charging an access fee to the insurance company ...
The POS is based on a managed care foundation—lower medical costs in exchange for more limited choice. But POS health insurance does differ from other managed care plans. Enrollees in a POS plan are required to choose a primary care physician (PCP) from within the health care network; this PCP becomes their "point of service".
GRAND RAPIDS, Mich.--(BUSINESS WIRE)-- The University of Michigan Health System (UMHS) has joined Priority Health as a participating provider to serve its HMO, PPO, POS and Medicare product lines ...
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.
v. t. e. In the United States, an exclusive provider organization ( EPO) is a hybrid health insurance plan in which a primary care provider is not necessary, but health care providers must be seen within a predetermined network. Out-of-network care is not provided, and visits require pre-authorization. Doctors are paid as a function of care ...
In the United States, health insurance helps pay for medical expenses through privately purchased insurance, social insurance, or a social welfare program funded by the government. [1] [2] Synonyms for this usage include "health coverage", "health care coverage", and "health benefits". In a more technical sense, the term "health insurance" is ...
The Health Maintenance Organization Act of 1973 (Pub. L. 93-222 codified as 42 U.S.C. §300e) is a United States statute enacted on December 29, 1973. The Health Maintenance Organization Act, informally known as the federal HMO Act, is a federal law that provides for a trial federal program to promote and encourage the development of health maintenance organizations (HMOs).
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