subject: Understanding The Five Basic Types Of Health Insurance Plans [print this page] Plans bought through Preferred Provider Organizations, Health Maintenance Organization, Exclusive Provider Organization, Point of service, and Fee for service are the five basic types of health insurance plans.
There are five general types of health insurance plans. Each have their pros and cons. To determine what type of health insurance plan is suitable to a customer, health insurance agents may use Health Insurance Leads. Nonetheless, before finally arriving at any type of decision, you are expected to do your home work like a smart insurance cover purchaser and comprehend what are the kinds of insurance covers available in the market.
Health Maintenance Organization (HMO)
One of the most common types of health insurance is the Health Maintenance Organization. The majority of American employees purchase their insurance through an HMO because this is typically what their employers offer them. Choosing an HMO is easier on your wallet and offer a variety of coverage. A broad network of doctors, specialists and healthcare facilities are provided to the policyholders of HMO. To direct all healthcare services and medical needs when needed, a primary-care physician works as a gatekeeper and is selected by policyholders. HMOs only take care of the charges if it is a procedure or you use a specialist that you were referred to. The downside of an HMO plan is that it is the most restrictive type of healthcare plan. Sometimes a plan requires that the patient pay a co-pay when visiting a doctor.
Preferred Provider Organizations (PPOs)
With an HMO, you must have a primary care physician to be able to follow through on a referral; however, this is not true when you are dealing with a PPO. It is less expensive for the policyholder to use the healthcare services and specialists in the PPO's authorized network. Services and facilities sourced from outside the network are more expensive and could require the insured to pay 20% of the total costs while the remaining 80% is covered by the PPO.
Exclusive Provider Organization (EPO)
EPOs are like PPOs but with a network that is smaller. EPOs are different than PPOs. For example with an EPO you don't get coverage for a specialist who is not a part of your network.
Point of service (POS)
Health insurance plans which fall under a point of service type is similar to PPOs since they also have a primary-care physician. They also let the insured to seek services from healthcare specialists outside its own network, however, is more expensive and needs additional paperwork to be complied.
Fee for service (FFS)
Fee for services is the least restrictive type of health insurance plan and offers a wider range of choices of medical specialists and facilities. To choose which doctor, facility or treatment they want, fee for service policyholders are given this discretion. Before the insurance provider gives money for these services, the insured has to pay a preset deductible amount. The insured is also normally required to pay 20% of the costs for every service he or she accrues. The maximum amounts are laid out for you in your insurance contract.
Unfailingly make a 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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