North Fork Properties small business employee handbook

 North Fork Properties small business employee handbook  

This is similar to the way an HMO works. Instead of the government paying the tab, you do through premiums paid to the health maintenance organization plan. These premiums are sometimes paid by individuals and sometimes by a group for its  North Fork Properties small business employee handbook .

When you join an HMO, you are called a plan member. As a member you are entitled to receive all of the health care you need, including preventive health services, with very little money coming out of your pocket by way of copayments or deductibles. Thus, the primary benefit of an HMO  North Fork Properties small business employee handbook  is almost complete control over out-of-pocket health care expenses. Once your premiums have been paid, you’re home free.

What’s the catch, you ask? Good question. Well, it’s this: If you join an HMO, in all but life-threatening emergency situations you must use the doctors and facilities authorized by the HMO. In other words, in return for lower premiums and little or no  North Fork Properties small business employee handbook  copayments, you give up your freedom of choice. You can only use doctors approved by the HMO.

This lack of freedom of choice can cause problems. While most HMOs have a wide selection of primary care physicians, they usually have far fewer subspecialists (such as cardiologist, gastroenterologists, rheumatologists, etc.) who are authorized to handbookle specialty care. And if you should need a subspecialist, your doctor may be reluctant to refer you since pressure is brought to bear on HMO physicians to keep costs down. Moreover, when a referral is made, it may not be the best subspecialist your doctor knows since he or she can only refer you to doctors who work with the HMO. Your choice of hospitals is also limited to those owned or authorized by the  North Fork Properties small business employee handbook .

Types of HMOs

There are three different types of HMOs, each of which outs a slightly different twist on the way health benefits are delivered to plan members.

The group model. Although the first group model was established in 1929 at a cooperatively owned hospital in Elk City, Oklahoma, by Michael Shadid, the most famous group model HMO is probably Kaiser Permanente, located in California and several other states. Group models are essentially partnerships among the medical plan, usually a large number of doctors who work within the HMO (called the group) and sometimes hospitals (as with Kaiser). The  North Fork Properties small business employee handbook  plan will only refer you to doctors in the group. In return, doctors will not work for anyone who is not a member of the plan. The doctors work in clinics and hospitals that are either partners in the HMO or contract with it to provide services. At the Puget Sound Health Cooperative in Seattle, decisions about patient care are made with the patient, the plan, and the doctors, with a lot of peer oversight to make sure costs are kept down and the quality of care is kept high.

…Continued in  North Fork Properties small business group health insurance