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PPO stands for Preferred Provider Organizations. This type of
coverage involves a network of health care providers that have
negotiated their rates with the insurer. When in need of care, you
simply go to any physician in the PPO's network. If you stay within
the network, your only out-of-pocket expense is a small co-pay. If
you go to a provider outside of the network, your PPO coverage will
pay only a percentage of the total bill.
HMO
(Health Maintenance Organizations) plans typically enable members to
have lower out-of-pocket healthcare expenses but also offer less
flexibility in the choice of physicians or hospital than other
health insurance plans. With an HMO you'll likely have coverage for
a broader range of preventive healthcare services than you would
through another type of plan. You may not be required to pay a
deductible before coverage starts and your co-payments will likely
be minimal. With an HMO plan, you typically won't have to submit any
of your own claims to the insurance company. However, keep in mind
that you'll likely have no coverage whatsoever for services rendered
by non-network providers or for services rendered without a proper
referral from your Primary Care Physician.
A
POS (Point of Service) plan combines some of the features offered
by HMO and PPO plans. As with an HMO, members of a POS plan are
required to choose a primary care physician (PCP) from the plan's
network of providers. Services rendered by your PCP are typically
not subject to a deductible. Also, like HMOs, POS plans typically
offer coverage for preventive care visits. Typically, however, you
will only receive a higher level of coverage for services rendered
or referred by your PCP. Services rendered by a non-network
provider may be subject to a deductible and will likely be covered
at a lower level. If services are rendered outside of the network,
you'll likely have to pay up-front and submit a claim to the
insurance company yourself.
The best health insurance plan depends on the following:-
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Are you going
to need long-term coverage or just something for the short-term?
-
Are you
looking for basic coverage or more comprehensive coverage?
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Would you
rather pay for your services before you use them or when you use
them?
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How important
to you is easy access to specialists?
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Do you have a
specific doctor or hospital that you would like to visit for
healthcare?
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What is the
most you could pay out in case of a serious illness or injury
Health
insurance is essential for ensuring your families good health and
safety unless you are independently wealthy you should have health
insurance; at the very least "catastrophic health insurance". |
