Health Insurance Plan

When it comes to health insurance, preventive care is one of the most important aspects because it has the potential to thwart problematic happenings before they occur. Health insurance can more or less be viewed as a type of investment in maintaining your health. As it is, if you do not allow for preventive measures, the health consequences could end up costing you a great deal more than the insurance costs themselves in the long run.

There is no single health insurance program under which everyone is covered. Such a program could not possibly take into consideration the needs of every citizen. As it is, you have options when it comes to purchasing health insurance. Providers offer differing plans that stretch across various diverse fields, flexing financial and health options from plan to plan in an effort to accommodate as many people as possible. Although there are subcategories and other such customized plans, there are predominantly 4 categories of health insurance from which to choose from. They include:

• Health Maintenance Organization (HMO)
• Point Of Service (POS)
• Preferred Provider Organization (PPO)
• Indemnity (Fee-for-service)

HMO plans are the least expensive, and therefore not surprisingly, the most commonly purchased health insurance plan available. They are the least expensive because they offer restricted access (Most restricted) to health care, keeping members within a small network through which services are covered. A set monthly fee covers the services received within said network, whilst the individual must pay any services received outside the network in full, totally removed from the HMO provider. HMO members choose a primary care physician (PCP) who is responsible for coordinating your health care. This includes:

• Routine & preventive care
• Treatment for illness & injuries
• Referrals to a network specialist or facility when necessary.

POS plans are slightly more expensive than HMOs and with that, offer a little bit more freedom with their health care services. As with HMOs, POS members select a primary care physician (PCP) who coordinates their care and makes referrals to other providers within the plan. Within a POS plan, you can refer yourself outside the plan & still receive partial health insurance coverage for the services. If your PCP refers you outside of the POS network, the POS will cover all or most of the incurred fees.

PPO plans are relatively more expensive than HMOs and somewhat more expensive than POS plans, offering more flexibility than both and better access to health care. Within a given PPO plan, you have the freedom to visit the doctor of your choice, however it should be noted that your costs will be far less expensive if you stay within the network whenever possible. Within the PPO insurance network, you pay a fixed amount that covers all your health care services. Outside of the network, you are responsible for paying a copayment that is based on higher charges. You will also have to meet the deductible. In some instances, you might also have to pay the difference between the health care fee & the amount that is actually covered through your plan.

Indemnity plans are the most expensive health insurance plans and with that, also allow the most freedom and the greatest access to health care. Indemnity plans have no networks through which members are tied into. You have the freedom to go the doctor of your choosing. After receiving health care services, you, the doctor, or the hospital, are responsible for submitting a claim to the health insurance provider so you can be reimbursed for the costs. Your health insurance provider will pay for all services designated through your Indemnity plan. Generally, you will be reimbursed for up to 80% of the health care service costs, & you will be required to pay the other 20% or so. Indemnity policies usually have an out-of-pocket maximum, meaning that after your expenses reach a certain limit in a given year, your insurance company will then cover 100% of all health care costs.

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Take a look at a list of   ( HEALTHCARE PROVIDERS )

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