Health insurance shoppers have very many plans they can choose from — over 13,000 as at the time of this writing. The fact is that there are over 13,000 health plans available for shoppers to choose from. Some will save you a lot of cash with a few compromises while others will cost you a lot with a lot of added value. Which you choose will depend on your health care needs and the size of your purse. Let’s take a look at your options…
You have two main options: Traditional health insurance and managed care coverage…
Traditional health insurance: This is insurance in its purest form. You have the full right to choose whichever health care professional or facility you prefer. No one chooses your doctor for you, for example. No one will also restrict you to a particular health facility or hospital. The usual process is to pay your bills and have your insurance carrier make reimbursements when you submit your bills. In other cases, a health care provider would have to send your bills to your insurer who handles payment.
If you want complete freedom to choice your doctor or health care facility, then traditional health insurance is your best bet. However, you also pay a lot higher than you would with managed care plans.
Managed Care Coverage: There are many plans that come under this heading. In spite of their differences, they have certain basic features: They combine the delivery and financing of health care services. This means you are some what restricted to a network of health care providers. However, you also get to pay far less.
Here are the different types of managed care plans…
1. HMO or Health Maintenance Organizations have health care providers that are contracted to them. Members pay a monthly amount for which they have access to health care services within the HMO’s network of providers. Each member is expected to make a pre-determined copayment for things like an emergency room visit, seeing a doctor or getting prescription drugs. This plan is valid only if a service provider in the network it used.
2. PPO or Preferred Provider Organization: This is an organization that is formed where a traditional health insurance provider gets into contract with a group of health care providers in order to reduce cost to its members. Insurers get the advantage of deliver better value to their customers while doctors in the organization get many more patients and prompt payments.
Members choose the health care provider they prefer. The downside is that the member would have to pay more if the health care provider they use isn’t part of the network.
3. EPO or Exclusive Provider Organization. Like the above, is an arrangement by a traditional health insurance carrier with a group of health care providers. But the difference is that if you are a member of an EPO you must only use a health care provider that has a contract with the EPO.
4. POS or Point Of Service Plans. policy holders have the freedom of choice in receiving health care from the network’s health care providers or outside at the point of service. But do bear in mind that you’d have to bear the following costs when using providers outside the network: Coinsurance and deductibles. Furthermore, they get less coverage if they go outside the network.
Irrespective of which plan you find most appropriate for your needs, you’ll have to get quotes and compare the various unique plans each shows you in order to get bigger savings.
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