Doug Henwood wrote:
> Nathan Newman wrote:
> >It is the HMO industry - at
> >loggerheads with the insurance folks
> Wait a minute. Don't Aetna and the Prudential (inscos are snotty
> about this - you're supposed to say The Equitable, not Equitable,
> too) have HMOs? Isn't an HMO structurally a kind of insurance company?
I'm going over my limit but this is how I understand it --
I don't know about Prudential but Blue Cross has HMO plans and PPO plans. Blue Cross contracts with HMOs to provide health care but in the PPO plan you can self direct your care. The HMO plans are cheaper and well you know how they operate with a network of doctors, providers, etc. The PPOs are more costly and allow you to choose your doctor, go where you want for medical care but Blue Cross is the overall insurance administrator for both systems.
Secure Horizons seperates itself from the HMOs so they can claim immunity from any HMO liability. They actually told me that they are not in the business of providing health care, that they were administrators only - but I think they only contract with HMOs. I don't think they offer PPO plans.
Kaiser is a different story. I believe it is the insurer and the HMO all in one.