Printer Friendly

TYPICAL HMO BENEFIT PACKAGE PROVIDES COMPREHENSIVE BENEFITS; REQUIRES MINIMAL OUT-OF-POCKET PAYMENTS

 TYPICAL HMO BENEFIT PACKAGE PROVIDES COMPREHENSIVE BENEFITS;
 REQUIRES MINIMAL OUT-OF-POCKET PAYMENTS
 WASHINGTON, June 17 /PRNewswire/ -- The typical HMO in 1991 provided its members a comprehensive benefits package with minimal out-of-pocket expenses for such services as hospitalization, primary care doctor visits and prescription drugs.
 This finding is from "HMO Industry Profile," the results of the annul national survey conducted by the Group Health Association of America (GHAA). This year's "HMO Industry Profile," which will be published later in 1992, analyzes data from 361 responding plans enrolling close to 29 million people.
 According to the survey, all responding HMOs cover primary care with no limit on the number of visits. While 76 percent require a copayment for primary care visits, the most common copayment is $5, and, generally, no extra charges are made for laboratory or radiology services.
 In addition, all plans cover hospitalization, 79 percent with no patient payment requirements.
 These benefits are a good measure of HMO coverage because physician care and hospitalization comprise the largest share of medical expenses.
 In addition, most HMOs cover pharmacy services without a dollar limit, and the typical copayment for a prescription is just $3-$5.
 "The true measure of health care coverage depends on a combination of benefits, premiums and out-of-pocket costs," said GHAA President James F. Doherty. "While many employees are increasingly subject to large deductibles and coinsurance, those who choose HMOs continue to receive comprehensive benefits with minimal out-of-pocket costs," Doherty said.
 HMOs' use of coinsurance, deductibles and exclusions for pre- existing conditions is very limited. The form of cost-sharing used by HMOs, a copayment paid at the time of service, is usually small enough (typically $5 for a primary care office visit, usually not more than $10) that it doesn't interfere with appropriate care, but does give members a financial stake in their own care and provides an effective check on inappropriate utilization.
 GHAA is the largest and oldest trade association representing HMOs and other similar managed care systems.
 -0- 6/17/92
 /CONTACT: Susan Pisano of Group Health Association of America, 202-778-3245/ CO: Group Health Association of America ST: District of Columbia IN: HEA SU:


TW-MH -- DC010 -- 1096 06/17/92 12:49 EDT
COPYRIGHT 1992 PR Newswire Association LLC
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1992 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Publication:PR Newswire
Date:Jun 17, 1992
Words:365
Previous Article:TAT TECHNOLOGIES LTD. (FORMERLY GALAGRAPH LIMITED) REPORTS ACQUISITION
Next Article:LIGHTING LUBE FILES EMERGENCY PETITION FOR 100 PERCENT BOND IN WITCO CASE, CITING WITCO'S DISCLOSURE OF POSSIBLE MAJOR ACQUISITION
Topics:


Related Articles
Trends in employer-provided health care benefits.
HMOs AND ORGANIZED HEALTH SYSTEMS POISED TO PLAY MAJOR ROLE IN NATIONAL HEALTH CARE REFORM
SPEECH BY AMA OFFICIAL RECOGNIZES BENEFITS OF HMOs AND SIMILAR ORGANIZED HEALTH SYSTEMS
CONVENTIONAL HEALTH PLANS HEADED FOR EXTINCTION AS EMPLOYERS SEEK TO CURB COSTS WITH MANAGED CARE
Understanding needs and concerns of the elderly regarding Medicare health maintenance organizations.
TWO PITTSBURGH TRADITIONS UNITE: JOSEPH HORNE CO. PICKS BLUE CROSS AND BLUE SHIELD FOR EMPLOYEE HEALTH BENEFITS
HMO ripoff.
Humana Offers Choice of Medicare Plans to Manatee County Seniors; Humana will provide Medicare HMO, PPO options in Manatee starting Jan. 1, 2005.
Medicare Modernization Act Promises Significant Enhancements in Health Plan Coverage Options for Medicare Consumers in 2006.

Terms of use | Copyright © 2016 Farlex, Inc. | Feedback | For webmasters