Choosing the proper health care plan for you and your family can be one of the most stressful, yet most important decisions to be made in life. You need to know what options you need, what options are available to you, and how much of your income you are willing to sacrifice for the safety net of a health care plan. When evaluating the literally hundreds of options available for many health care plans, it is important to stay focused on two primary issues: budget and need.
Gathering health insurance quotes and finding the area where budget and need meet is a daunting task; wading through pages upon pages of documents and finding which specific plan works best. This article will outline the four most common types of health care plans, and how they will work for you and your family.
Health Management Organisations (HMOs):
Health management organizations (HMOs) are low-cost, low choice plans where you must choose a primary care physician to coordinate all of your healthcare needs. Because of this, any appointments with specialists must be referred by your primary care physician to be covered by the HMO. You are also limited to only see doctors that are within the HMO’s network, which can be an enormous hassle in the case of emergencies. HMOs typically have low co-pays and full prescription drug coverage, so if you see your doctor often or incur the majority of your health care expenses in paying for your prescription drugs, this plan may be right for you.
Preferred Provider Organisations (PPOs):
Preferred provider organizations, (PPOs), consist of health care providers who have made deals with insurance companies to offer discounted rates, which are then passed along to you. In return, the insurance companies send their patients exclusively to doctors within the PPO network, increasing business for the health care providers. You will not need to get a referral to see a specialist, but you will need to ensure you see a doctor who is part of the PPOs network to utilize the discount. You will be responsible for a small copayment when staying within the network, and a far larger one if you go outside of the PPO. Prescription drugs are also covered under a PPO with a small copayment due to the pharmacy that fills the prescription(s).
Point Of Service Plan (POS):
A point of service plan, (POS), combines parts of HMOs and PPOs. Like an HMO, you must have a primary care physician who can refer you to specialists within the POS network. You are responsible for a co-payment when seeing a doctor within the POS network, but are not required to pay a deductable. However, if you do not get referred to a specialist within the POS network, your visit will still be covered, but there will be a deductable you must pay.
Fee For Service Plans:
A fee-for-service plan offers the most expensive, yet liberal, health care coverage. They pay you back around 80% of your health care bill after you pay it yourself. Typically, you will send your fee-for-service plan representative your medical bill, and they will cut you a check for 80% of it. Technically, it works out to you paying a 20% co-pay for every health care related service you receive, and you are free to go to any doctor you want.
Most fee-for-service plans have a cap on how much you can receive per year. So if you require extensive health care related services, you must be careful not to exceed the predetermined cap in benefits set by your fee-for-service plan.
Regardless of which health care plan you choose, the peace of mind afforded by having health care coverage is palpable.
Let’s Have Your Suggestions And Views:
Which health care plan do you have for yourself and your family? Are you satisfied with the plan? What would you suggest to our readers about various health care plans?
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