Whether you seek health insurance through your employer or on your own, you will be offered a variety of plans. In order to make the right decision about which plan is right for you, it is important to know the basic features of the most popular types of health insurance. After that, it is wise to get many quotes on health insurance and compare them. It's a free way to compare plans and prices.
Service charge
For many years, the fee-for-service plan was a very popular and widely used type of health insurance. The insured pays a monthly contribution. A deductible is applied to the cost of the services. Certain services related to healthy living or emergency services may be exempt from the deductible. Once the deductible has been paid, the insured and the insurance company share the cost of the services. For most companies, the split can be 80/20 or 70/30. The company pays eighty or seventy percent, the insured pays twenty or thirty percent. There will be a cap on the total amount of money the insurance company will pay out over its lifetime.
Health Maintenance Organization (HMO)
HMOs have become increasingly common over the past decade. Again, the insured pays a premium which makes him a member of the HMO. As a member of the group, the member has the right to visit any of the doctors who are part of the group. These physicians may all work together in an HMO facility or may work in individual clinics as part of a group of physicians under contract with the HMO. Members may have to pay what is called a copayment when they visit the doctor. No documents are necessary to validate the requests of an HMO member; however, members can wait longer for non-emergency appointments than they would with a fee-for-service insurance program. An HMO generally requires its members to have a primary care physician who then refers them to a specialist if necessary.
Preferred Supplier Organizations (PPOs)
The PPO, a mixture of the fee-for-service model and the HMO model, is a growing sector of health insurance. As in an HMO, there is a network of doctors among whom the insured person chooses his doctor. This doctor is responsible for designating the need for specialized care. A co-payment will be required during an office or hospital visit. There will also be a deductible and medical costs will be split according to a scale agreed between the insured and the insurance company operating the PPO. A person can choose to call on a doctor outside the network. Expenses incurred for out-of-network medical care will increase the patient's share.
Please collect as many quotes as possible to compare services and prices. It's a free way to learn a lot about all your options.
