What do PPOs, HMOs, and POS plans have in common? They are all forms of managed health plans, and you need to be familiar with them when you shop for health insurance. PPO means preferred provider organization; HMO means health maintenance organization, and POS means point of service.
Usually managed care plans give their customers different health care from a network of certain providers. That means members are only able to go to certain hospitals and doctors that are only in that network. They do also take care of processing claims from medical service.
HMO’s often provides less expensive health care. You pay a fixed monthly premium in exchange for medical services. HMO customers though, have no choice in what hospitals and doctors they choose. They can only use the ones in their network. A referral from an HMO primary care doctor is needed in order to see a specialist so normally doctors from a HMO will refer patients to other HMO doctor members.
A PPO gives their customers from freedom in choosing what doctors they can see. Members can refer themselves to doctors or specialist outside of the plan although, doctors can also make referrals. However even though clients have more freedom to go outside of the network for medical services, they will have to pay more to do so.
Though members will pay more, In a point of service plan, doctors can refer their patients to other doctor within or outside of the plan. Members of this plan are able to pick their own doctors for medical care and can refer themselves to which ever health care provider they choose to.
It is also important to understand fee-for-service, or FFS, plans. These are not really managed care plans in the sense that there is a pre-existing network of providers in place. Fee For Service plans are often much more expensive in comparison to HMOs and PPOs. However, FFS plans allow participants greater latitude in who they can see. FFS beneficiaries can choose what doctors, and specialists they prefer to see and what hospitals they can go to. In an FFS, what determines what provider members use is whether or not the provider accepts the insurance. Normally, FFS plans require much more in out-of-pocket expenses and require members to pay in full up front and then file for reimbursement.
The plan you ultimately choose will depend on personal needs, whether or not you are single, married, married with children, whether or not the insurance is available in your geographical area, and of course, the amount of income available for health insurance. One very important point to remember is that health insurance, as all insurance, is protection. The better you understand the kind of protection you need, the better your choice will suit your needs.
Go online to find the right health insurance for you. And if the insurance you currently have is the best for you.
Want to find out more about low cost health insurance quotes, then visit Sara Bacon’s site on how to choose the best health insurance plans for your needs.