Today in this Article we will learn and know the most commonly available health insurance Plan Types. So here we go…
Health Maintenance Organization(HMO): The health insurance company negotiates discounts rates (“Contracted Rate”) with a number of different kinds of health care providers(these make up a “Network”). You must use these health care providers in order to receive any of the benefits of your plan. You always start by seeing your primary care physician who determines when you need to be referred to a specialist or other type of health care provider. If you see any health care providers outside of the network, or if you use any health care providers outside of the network, or if you do not receive a referral from your primary care Physician for certain types of service; you have no benefits and must pay all costs out of your pocket(expect in the case of the emergency). This kind of plan offers the least amount of choice in health care providers but is the most predictable for cost and is the least expensive for you. These plans are not offered very frequently today.
Preferred Provider Organization (PPO): Has a Network of health care providers like an HMO has but patients can self refer to a specialist. “Self-refer” means you can go see a specialist directly when you know that is the kind of doctor you need; you do not need to start by first seeing your Primary Care Physician. It also comes with an Out-of-Network option that costs you more out of pocket but gives you more choice in health care providers.
Exclusive Provider Organization (EPO): Finaly third largest catgory of health insurance plan is called EPO. In my opion; this is just a new word for HMO. And just like an HMO, you can’t go outside the Network for care with this type of plan. When you shoping for health insurance plan types or when you looking for option available to you, you frequently see subcategories. Here is one example of PPO Plan.