Which of the following is a type of commercial health insurance arrangement?

• A. Health Maintenance Organizations (HMO)
• B. Medicare
• C. Medicaid
• D. Self Pay

Answer: (A)

Commercial health insurance arrangements are private, prepaid plans offered by insurers or employers that contract with networks of providers to deliver care. Health Maintenance Organizations are a classic example of this type of arrangement, focusing on managed care within a defined network and usually requiring a primary care physician and referrals for specialists. Medicare and Medicaid, by contrast, are government programs funded and administered publicly to cover specific populations. Self pay means paying for services out of pocket with no insurance coverage. Because HMOs are private, prepaid, network-based plans, they fit as a commercial health insurance arrangement.