PREFERRED PROVIDER ORGANISATIONS PPOs

1
Health Care Providers
2
Medicare

• Part A
• Part B
• Enrollment

3
HMO's

• Origination
• How the plan works
• Concerns
• Questions to ask

4
Point of Service (POS)

• Similarities with HMO
• Differences with the HMO
• Drawback on Right to Choose

5
POS Advantages

• Employer Advantages
• predictable costs
• One plan, one risk pool
• One company administration

• Employee Advantages
• More coverage
• Lower out of pocket cost
• Freedom to choose

6
Preferred Provider Organization (PPO)

• Definition
• Offers more flexibility
• Features of PPOs

7
Features of PPOs
? Combined features ? How it is organized ?
Contracts with networks
? Financial Penalty ? Efficiency ? Monitors
8
Sources

• Http//ideanurse.com/hmo.html
• New York Times, August 17, 1997
• How to Make Your H.M.O. Blink
• 1997 Guide to Health Insurance for People with
  Medicare
• 1st Book of Health Insurance Data 1995
• Mutual of Omaha Representative
• John Heenan