Medical Plan Comparison Paper: HRM 425 - Benefits, Safety and Health

Essay by ShanrachelleUniversity, Bachelor'sA+, November 2006

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Health care coverage should be accessible and affordable to all Americans. Employers should voluntarily provide health insurance coverage to their workforce.

Numerous types of health care coverage are available through the voluntary, employer-based system, including HMO's, PPO's, POS's, and EPO's. Allowing employers to determine the best health plan model for their organization, based on the needs of the workforce, is extremely important to ensure employee satisfaction and reduce health care spending.


Health Maintenance Organization (HMO) is a type of insurance where an individual is responsible for paying a percentage of a bill every time care is received. Additionally, a deductible may be added that the individual must pay before the HMO will start picking up the remainder of the bill. Like most other insurance providers, HMO members pay a monthly fee no matter how much he or she use in medical coverage. HMO's focus is to reduce the cost of out-of-pocket expenses.

With this type of insurance individuals, tend to see their physicians for medical problems before the problems become more severe. A HMO will not pay for non-emergency care providers, and can be extremely strict with what constitutes as an emergency.

HMO's not only provides medical care but also delivers the treatment by having doctors, hospitals, and insurers participate in this program. HMO individuals must receive his or her medical treatment from physicians or a facility in the HMO network. For an initial visit for medical treatment, he or she must choose a primary care physician (PCP). This person will be his or her primary care provider. When going to a specialist, the individual will need to consult his or her PCP. This keeps the HMO costs from increasing as rapidly as other insurance providers increase. HMO's will also continue to cover an individual's treatment without placing...