From the course: Risk Management and Insurance Planning: Designing for Client Needs
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Provision health care services
From the course: Risk Management and Insurance Planning: Designing for Client Needs
Provision health care services
Now that we've discussed the different costs that people can face in healthcare, we need to turn to healthcare provisions, because different plans have different arrangements. There are two key provisions I want to highlight. One is healthcare network, and two are primary care physicians, or PCPs. The healthcare network refers to a group of doctors, hospitals, and clinics that the insurance companies have contracted to provide plan members with healthcare services. The size of the network can vary, as can the costs for receiving non-emergency care outside of the defined network. Using a network drives down the cost of the plan, but it also restricts where plan members can access healthcare. The second key element is the primary care physician, or PCP, which is typically someone's family doctor. Some health care plans use a primary care physician as a gatekeeper. This means that the primary care physician oversees authorizing the patient's referrals, hospitalizations, and lab studies…
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