Understanding Health Insurance Policies: PPO vs. HMO Explained
Learn about the key differences between PPO and HMO health insurance policies, including concepts such as monthly premiums, deductibles, co-pays, and coinsurance. Discover how these factors affect your out-of-pocket costs and access to healthcare services. Gain insights into making informed decisions about choosing the right insurance plan for your needs.
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Health Care Objective: To illustrate the difference among different _________insurance policies. STUDENT FILL-IN NOTES
PPO: ____________________ on the insurances, Preferred Provider List, if you want them to pay for most of it. _____ required to go through your primary doctor for all visits. Typically more expensive.
HMO: ____________________ Group insurance that entitles members to use services at participating _________. oTraditionally: lower monthly payments and co-pay. Doctors _______ as gate-keepers to care.
Monthly Premium Monthly ________ for insurance plan.
_________________ A specific dollar amount that your health insurance company may require that you pay out-of-pocket each year before your _______ insurance plan begins to make payments for claims. o Not all health insurance plans require a deductible. o As a general rule (though there are many exceptions), ____ plans typically do not require a deductible, while most ______ plans do.
Office Visit (________) An office Co-Pay is a monetary amount you pay ($$) when you see the doctor, or dentist for ______ care.
Coinsurance The amount that you are obligated to pay for covered medical services after you ve satisfied any ___________ or deductible required by your health insurance plan.
Health Care Activity 89 Utilize the following for average cost of health care in California. o Government Health Care / Free Clinics- ~$1,200 o HMO - $13,122 / 12 = $_____________ o PPO - $13,937 / 12 = $_____________ Divide the sample annual costs from page 94 by 12 and put that dollar amount on the, Health Care line [9]. Place that figure on Activity 92 on line [9].
Average Cost http:..www.usnews.com/articles/opinion/200 9/05/26/healthcare-costs-rising-for-average- family-of-four.html www.ehealthinsurance.com
Activity 118 Let s look at your lifespan. The horizontal bar represents the average lifespan of 78 years. Already filling in time for your schooling to this point, you will have 60 years to play with. Envision your ideal future. How will you spend your time? Think about the job you would most like to have REGARDLESS OF HOW MUCH TRAINING AND SCHOOLING IT TAKES TO GET THERE.
Activity 118 Continued Using polka dots, fill in and label the years you will be in college or training. Using horizontal stripes, fill in time for full time work. Using diagonal stripes, fill in time for part-time work. Using stars, fill in and label the time outside the workforce for raising a family or retirement.
Activity 119 How many years of post-high school training will you complete? (A) 4 or 5 years? How many years do you think you will work full- time? (B) 43 or 47 years? How many years do you think you will work part- time? (C) 4 or 5 years?
Activity 119 Multiply 2,080 x (b) 40 years. This will be your answer for (f) 83,200 hours. Multiply 1,000 x (c) 5 years. This will be your answer for (g) 5,000 hours. Add (f) + (g) together = 88,200 hours. This is how many hours you will work in your lifetime. Look at the formula at the bottom of the page in your workbook. Then write this total on the line above it. For every year of post-high school education, you will work 11 years 3 months. Schooling isn t all that bad after all is it?
