Health Insurance Coverage

With sky high medical expenses, it is not possible for every individual to seek out an affordable medical care. Having health insurance can help individuals in seeking quality and affordable medical care. Health insurance coverage ensures that individuals get proper treatment without feeling the burden of intricate medical bills. Choosing the right health insurance plan is very crucial; and expert guidance can also be taken for the same. Look for different health care plans, compare them and then choose the right one.

Health Maintenance Organization (HMO)

The HMO is a sort of managed care organization, which is entrusted with the mission of providing excellent health care services to all the members through a network of well-known hospitals and experienced health care professionals. The HMOs are often considered as the better substitutes for the conventional health insurance plans; and less of the costs involved in HMOs. The objective of these programs is to deliver the best of the health care services for the members at a lower cost via the well-organized network of health care providers. The health care plans sponsored by the employers are usually through an HMO. The HMOs plans are open for individuals, family members or, employers. HMO members are required to pay a premium to get access to the prepaid medical care.

Preferred Provider Organization (PPO)

The PPO is similar to the health maintenance organization (HMO) in various aspects. They provide medical treatment services through a chain of famous hospitals and highly-qualified doctors. PPO members are required to make a premium payment to get access to the services similar to HMOs. The difference between HMOs and PPOs is that in the latter case, the members undertaking the plan are allowed to adopt health care plans which do not fall in the purview of the PPO network. All the members are required to pay an annual deductible at the start of the PPO. Under PPO, the members of the network need not a referral from the primary physician to avail treatment of a specialized doctor; however, HMO members require a referral. The main advantage of PPO is the greater options associated with it.

Point of Service Health Insurance Plan (POS)

It is a blend of the attributes present in Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO). It is analogous to HMO as the members are required to assign a doctor who falls into the network to act as the primary health care provider of health services. The similar aspect between PPO and POS is that the members are provided with full freedom to opt for the services of the other outside provider of health services. The members are required to pay the entire costs in the event of no referral being made by the primary care provider to the outside provider of services.

Free for Service (Indemnity) Health Insurance Plan

Free for service delves into the details on the payment method used to remunerate physicians who are present in the network of health insurance plans. Physicians who are remunerated under this plan counter less of the financial risks. Physicians are allowed to augment the number of services per visit. Physicians are then paid by the health plan for every procedure and test they conduct. Physicians getting remuneration under this plan never avoid the procedures and the tests which are very expensive.