Understanding The Five Basic Types Of Health Insurance Plans

Insurance bought through a Health Maintenance Organization, Preferred Provider Organizations, Exclusive Provider Organization, Point of service and Fee for Service are the 5 basic types of health insurance plans.

As each type has its own set of benefits and limitations, typically, health insurance plans fall into 5 basic types. Insurance agents sometimes use health insurance leads to help them figure out which plan is the best for their client. Be sure to do your homework and have a good understanding of the different types of insurance you may choose from before you go insurance shopping.

Health Maintenance Organization (HMO)

One of the most common types of health insurance is Health Maintenance Organization. Most Americans buy their insurance through an HMO because that’s the way most employers do it. Choosing an HMO is easier on your wallet and offer a variety of coverage. HMOs offer complete care networks. The policyholders selects a primary-care physician who works as a gatekeeper to direct all healthcare services and medical needs when needed. When the primary-care physical refers the patient to the specialist or medical service, only expenses http://stringerdivorcelaw.com will be covered by the HMOs. The drawbacks of an HMO plan is that, out of all healthcare insurance options, it is the most restrictive. Some doctors require you to pay a co-pay before being seen depending on your insurance policy stipulations.

Preferred Provider Organizations (PPOs)

A PPO does not require you to get referrals. But, cost-wise it is advantageous if the healthcare services and specialists chosen by the policyholder are within the PPO’s own prescribed network. It is more expensive to source service and facilities from outside as it may require you to pay http://vaccarolawoffice.com 20% of the total cost in advance and the remaining 80% is covered by the PPO.

Exclusive Provider Organization (EPO)

Somewhat similar to PPOs, but with a distinctly smaller network are Exclusive Provider Organizations, or EPOs. Unlike PPOs, EPOs usually do not provide coverage for services rendered by specialists outside their own network.

Point of service (POS)

Health insurance plans that fall under a point of service type is similar to PPOs in that they also have a primary-care physician. These will allow the insured to go to specialists at their own discretion.

Fee for service (FFS)

This is the least restrictive type you can get, and actually offers a wider range of specialists and facilities. To choose which doctor, facility or treatment they want, fee for service policyholders are given this discretion. First, the insured must pay the deductible amount (a preset number), then the insurance provider can pay for the services. The insured is also usually required to pay 20% of the costs for every service he or she accrues. A maximum amount that the insured is required to pay is stipulated in the insurance contract.

Unfailingly make a http://luissanchezrealty.com complete overview of your coverage needs and your financial possibilities when deciding on a health insurance plan. Strive to balance the before mentioned aspects to get the plan best fitted to your situation.

By: danica

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