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healthcare plans

• HMO (Health Maintenance Organization)
• POS (Point of Service)
• PPO (Preferred Provider Organization)
• Indemnity (Fee-For-Service)

HMO: This type of healthcare plan is the most commonly purchased healthcare plan due mainly to the fact that it is the least expensive option available. HMO healthcare plans are relatively inexpensive due to the fact that they offer the most limited access to care. HMO healthcare policyholders need to select a PCP (Primary Care Physician) who will handle their care whenever necessary. Your set monthly healthcare fee will cover your visits to your PCP. Your PCP will coordinate all of your healthcare including:

• Routine / preventive care
• Treatment for illnesses and/or injuries
• Referrals outside of the HMO network to a specialist or facility if necessary. *

* If you travel outside the network to visit another doctor such as a specialist, you will be responsible for the bill.

POS: Aside from HMO plans, POS healthcare plans are the most affordable plans available. As with HMO healthcare plans, POS plans require the policyholder's selection of a PCP who will coordinate the majority of their care. The policyholder needs a referral from said PCP should he/she need to visit a doctor outside of the network. Under such circumstances, the majority of the bill from the referred doctor's service will be covered by the POS policy. You can also refer yourself outside of the POS network, however you would be responsible for paying coinsurance.

PPO: Although PPO healthcare plans afford policyholders a greater degree of flexibility, they are also more expensive than either a POS or an HMO plan. PPO policyholders are free to visit the doctors of their choice, however their monthly costs will be less expensive if they choose to stay within the PPO network. (Approximately $10 / office visit or prescription) Outside the network you will be required to pay a copayment based on higher charges & you will need to meet the deductible.

Indemnity: Indemnity plans are the most expensive healthcare option available, however they are also the most flexible. You are not tied into a network of doctors in any way, and are free to choose the physician of your choice at any time at no higher a cost. Following your visit, you, your doctor, or the medical facility are required to submit a claim to your insurance company. They will then cover all costs designated by your customized Indemnity healthcare plan. (Generally, the plan will cover 80% of the incurred expenses. You will be required to cover the additional 20% remaining)

Indemnity                                  PPO                                  POS                                  HMO

More Expensive   <---------------------------------------------------------->    Less Expensive

More Freedom of Choice   <--------------------------------------->   Limited Options for Care

* Chart reproduced from www.thehealthinsurance.com

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Check out our brief list of common ( HEALTHCARE PROVIDERS )