Finance Tips

When it comes to insuring ones health there’s no denying the fact that this form of insurance is a must for everyone even though it’s not legally required and is purely optional. It’s hard to imagine the current healthcare system without insurance because otherwise people couldn’t afford most medical services and doctors wouldn’t get their high salaries, which are among the highest all over the world. Thanks to insurance both customers and service providers are pleased, and everyone’s getting the thing they want. Among many types of insurance available managed care plans are the most widespread, so let’s take a closer look at some of the most common forms of insurance offered by insurers:

Health Maintenance Organizations (HMO)

This is the most common form of managed care plans as it provides the lowest price and a wide range of services included. It’s main drawback is the lack of flexibility in what concerns the places you get care from. Under HMOs you are limited to a network of facilities and specialists you may get care from and covered to the full extent. If you choose to get your services from someone outside the network your costs won’t be covered at all. Moreover, you are required to choose a primary care physician who will refer you to all the required specialists, so there’s more paperwork involved with this type of plans. Yet, you usually pay lower premiums for that so it’s really worth the effort.

Preferred Provider Organizations (PPO)

Preferred Provider Organizations offer more flexibility but for a higher price if compared to HMO plans. You are still limited to a network of providers to get care from, however if you choose to go out of network there will still be some part of your bill covered only to a lesser extent compared to in-network services. And you aren’t obliged to choose a primary care physician so there’s not so many office visits to do under this type of managed care plans. If you have the additional money and want more flexibility with your health insurance this plan type will definitely appeal to you.

Point Of Service (POS)

Point Of Service plans are often referred to as a mix of HMO and PPO plans as they provide the benefits of both these forms of health insurance. You gain the flexibility of PPO in what concerns the places you get services at, yet you still have to choose a primary care physician and have a network of providers to work with. One of the greatest benefits is that you may choose your family doctor as a primary care physician even if he or she doesn’t make part of the insurer specified network, which is definitely appealing to those who have long term relations with their family doctors. PPO plans may vary in price so it’s really recommended to shop around if you want to get the best rate possible.

As you see, managed care plans come in different forms with the sole purpose of giving you exactly what you need. So it’s really important to assess your individual health insurance needs before choosing the plan type to address them adequately.

You want to insure your health and ask your insurance agent to offer you a good policy. You are given quotes and start thinking about buying a certain plan when the inevitable question is asked “What type of plan do you want to purchase?” This question has left many first-time insurance shoppers confused as they didn’t know about any plan types before. Too bad, because by choosing the type of insurance plan you will pay for determines how your coverage will be distributed as well as how your medical services will be provided. And as you may guess this is crucial when it comes to insuring own health.

But do not worry, this article will explain the essence behind each coverage plan type you can get in the US so the next time you will be asked the question of plan types you would choose the perfect plan to meet your requirements.

HMO (Health Maintenance Organization)

HMO plans are the most popular type of managed care distribution these days. They provide a wide spectrum of healthcare services you can receive for a reduced fee or free of charge. But the main catch is that you can receive them only at specific locations and from specific professionals. And you will have to choose a primary care physician (PCP) who will refer you to other professionals when needed. Without your PCP’s affiliations you won’t be able to receive coverage for the services you took. Neither will you be covered for the costs if you address someone outside the network.

PPO (Preferred Provider Organization)

PPO insurance coverage is quite alike to HMO. This type of managed care also requires you to choose a PCP, however you have more options when choosing this doctor. This is especially useful to those who have a good relation with their family doctors who might be outside the insurance company’s network. Moreover, you have fewer restrictions on out-of-network services, still you will eventually pay more for them if compared to in-network services.

POS (Point of Service)

POS health insurance plans also require you to choose a primary car physician. But you aren’t restricted to a network your insurance company has. Still, it will be impossible for you to get individual health insurance coverage if you don’t get a referral from your PCP before visiting any other doctor.

EPO (Exclusive Provider Organization)

EPO health insurance coverage is almost the same as HMO plans. There’s a PCP you have to get a referral from in order to visit a specialist and there’s a network of physicians and facilities you are limited to. The only difference is that you pay only for the services you received, while with HMO plans you have to pay a regular monthly fee.

Fee-for-Service

This type of insurance coverage is the oldest out there and least complicated to understand. You have no restrictions on where to get your care or whom to address. You only pay for the services you receive when needed. However, you get less coverage with such plans and your overall expenses tend to be higher than with managed care plans.