Health Insurance Plans
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There is a wide choice of Health Insurance plans available. They include HMOs, PPOs, POSs and Major Medical. We will take a look at how these plans work. |
HMO stands for Health Maintenance Organization. This kind of plan works on a network or list basis, made up from a variety healthcare professionals, such as hospitals, doctors, specialists and services. Members are entitled to receive treatment from the medical providers within that network. In most cases the insured chooses a local doctor from the network, who will act as their Primary Healthcare Manager as well as being responsible for their primary medical needs. This is known as Managed Care. When required, the Primary Healthcare Manager will refer patients to other specialists and services within that network. HMOs work within specific service areas. Individuals state their zip code during the application process so that they can be assigned to specific networks. The benefit of a network means that HMOs are generally lower cost options. A PPO is a Preferred Provider Organization. It is similar to an HMO in terms of network, but the individual is not limited only to services provided by that network. However, costs might be higher for services outside of the network. POS means Point of Service. POS plans are similar to HMOs in that they operate Managed Care, whereby the individual chooses their primary healthcare manager. However, like PPOs, referrals from that doctor do not have to be within the network, offering individuals more options than an HMO. Major Medical Insurance operates along the lines of traditional health insurance. The individual is only entitled to insurance payments after they have paid the pre-agreed annual deductible. Once this has been paid, the insurer will pay 80% of medical costs, and the insured is responsible for the remaining 20%. These plans offer individuals freedom to go to any health service they choose. When choosing a Health Insurance Plan, it is important to spend time assessing individual needs in terms of medical requirements and expenditure, current situation, would the insured be thinking of starting a family in the near future for example, and realistic affordability. Most plans tend to be quite flexible in terms of cancellation, but these terms should always be checked before purchasing a particular policy.
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Health Insurance Plans
