Health Care Plans with Their Basic Features
Different health care plans provided by health insurance companies have distinct features. These plans are discussed below, and you should read them before you make a resolution.
Health Maintenance Organization (HMO) offers all health services through a network o providers and centers. Its features include limited freedom to choose a
provider. There is very little paperwork to do when compared with other plans. Seeing a specialist requires that you be referred by a primary doctor. You can get service from any of the HMO network doctors. I case you seek services outside the network; you will pay the full bills by yourself. If it is emergency services that are sought out of network, they will only pay the in-network rates. You will be obligated to pay monthly premiums and deductibles. Deductibles are made before your plan matures to cater 100% of your care. You may enter in a copay plan where you pay a flat fee whenever you get a service. An alternative is co-insurance where you pay a cretin percentage of your medical costs
Preferred Provider Organization (PPO) plan gives a degree of freedom to select a health service provider. You also do not have to get a referral from a primary doctor care to get specialist care. In case you go for an out-of-network provider, you incur more costs from your pocket. In this case, you will also do a lot of paperwork. You will get services from any of the PPOs network doctors. The copay and co-insurance schemes also apply here. There are some PPOs that have deductibles especially if you see an out-of-network doctor. Monthly premium has to be met. If you say an out-of network doctor, you will have to pay him and ask for payment from the PPOs.
The Exclusive Provider Organization (EPO) also provides relaxed freedom to select a health facility. It gives you freedom to select a specialist without a referral from a primary healthcare. Unless it is an emergency, they do not pay for any service you get from an out-of-network provider. It offers lower premiums than a PPO issued by the same carrier. There is no paperwork involved with an EPO. The copay and co-insurance apply just like the other plans. Some of them may have deductibles.
Point of service plans
has features that resemble those of the HMO. It gives you the best freedom to choose a service provider. There is some paperwork from doctors, not in the network. The primary doctor coordinates the referrals to the specialists.