| |
Indemnity |
PPO |
HMO |
| PAYMENT |
Providers are indemnified or reimbursed for services |
Providers are paid on the basis of a discounted fee scedule |
Providers are paid a dollar amount per member per month regardless of services rendered, and regardless if patient shows up |
| BENEFITS |
The levels and coverage are defined by a contract. |
Enrolled members receive services at a reduced cost. |
Enrolled members receive minimal benefits and services. |
| PATIENT'S FREEDOM OF CHOICE |
Patient chooses doctor; the most freedom of choice. |
Patients are not locked into one dentist but pay more for care from a non-preferred provider. |
Patients are locked into designated providers; least freedom of choice. |
| UTILIZATION |
May or may not be controlled by the carrier. |
Less controlled than an HMO. |
Providers receive a financial incentive to control utilization. |
| COST TO PATIENT |
Most expensive |
Less expensive than an indemnity plan. |
Least expensive |
