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What's the Difference In all the Health Insurance Plans?
With all the different health care plans out there, it can be hard to make sense of them all and find the plan that's right for you and your family. You can choose between HMO's, PPO's and POS's. What do those terms even mean? Once upon a time, insurance was a simple process. You went to the doctor or hospital of your choice and when the bill came you and the insurance company both paid the appropriate amount on the bill and went on your way. It's no longer that simple; plans have changed considerably and while health insurance plans have generally gotten better, they've also become more confusing.
A PPO, or Preferred Provider Organization, is a type of managed care health care plan. It's the closest to the old style of indemnity health care plan that people remember from years ago. A PPO has certain hospitals, doctors and other health care providers that they have made an agreement with to accept lower fees from those insured through their organization. You can end up paying less for your health care needs with a PPO style health care plan. You will have a low co-pay if you go to a doctor in the network, but if you have to go out of the network for coverage, you will have to pay much more and might not be covered by the health care plan.
An HMO or Health Maintenance Organization is a group or team of health care providers. You visit them in large conglomerate health centers. Kaiser Permanente is an example of an HMO. HMO's will allow certain doctors to practice outside the group. These are called individual practice associations. HMO's allow members to a large variety of medical services in a central location. Once again, if you go to a doctor outside the plan, you will have to pay the difference between what the doctor charges and what your insurance will pay.
A POS, or point of service plan, is offered by HMO's and is an indemnity type of option. This allows doctors to refer patients to other doctors outside the plan and patients can choose to visit a doctor outside the plan on their own and still receive some coverage from the insurance plan.
Other types of health insurance plans exist, but these are the most prominent and are usually what employers offer. Talk to your health insurance plan's representative to determine exactly how much and what type of coverage you need; this will dictate part of the cost of your premium. The rest of the cost of your health insurance plan will be based on your own and your family's medical history, fitness and habits like smoking.
Jeanett Branson, of Boston, Massachusetts, found herself in need of a health insurance plan and decided to check out local insurance agencies, rather than going through her employer. She found a plan that fit her needs better and offered better coverage than what she could have otherwise obtained.
