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Types Of Health Insurance Plans
By: Ariful Anam
There are a variety of affordable health insurance plans to choose from, they
include;
- Managed Care Plans
- Fee-of-Service Plans
- Health Maintenance Organizations (HMOs) Plans
- Point-of-Service Plans
- Preferred Provider Organizations (PPOs) Plans
Managed Care Plan
Managed Care plans help insurers to control costs. Here the insurance companies
sign an agreement with doctors and hospitals to provide health care services for
their members. In a managed health care plan, you choose to visit doctors and
hospitals from the insurance company's network list of hospitals and
specialists. If you want to see a doctor outside your plan, you will have to pay
more. Most people get their managed care health insurance through their jobs.
Here the employer pays the managed care plan a fixed amount of money in advance
to pay for all your health care needs. You pay only a small amount.
Fee-of-Service Plan
In a Fee-of-Service plan, the insurance company pays part of your doctors and
hospital bills, while you pay a monthly premium fee. This is a traditional form
of health care. Here the insurance company basically pays fees for the services
provided to the insured people covered by the policy. With this type of health
plan you get the best choice of doctors and hospitals. To receive a claim for a
fee-of-service plan you have to fill out forms and then send them to your
insurance company. You also need to keeps receipts and bills for your medication
and other medical costs. In this plan you are basically responsible for keeping
a track of your own medical expenses.
There are two kinds of fee-of-service coverages - basic and major medical. Basic
coverage covers the cost of the hospital room and care while you are at the
hospital. It also covers some hospital services and supplies, such as x-rays and
prescription medications. Basic coverage also extends towards the cost of
surgery, whether it is preformed in or out of the hospital and for some doctors
visits. Major medical coverage on the other hand covers the cost of long term,
high cost illness or injuries.
Health Maintenance Organizations (HMOs) Plans
An HMO plan is a pre-paid health plan, where you pay a monthly premium. This
plan provides comprehensive care, including doctor's visits, hospital stays,
emergency care, surgery, lab tests, x-rays and even therapy if needed. Under
this plan, your choice of doctors and hospitals is limited to the doctors and
hospitals under contract with the insurance company. However, in the case of
medical emergencies exceptions are made. As HMOs receive a fixed monthly fee,
they make sure that you get basic health care for any injury or illness before
it becomes serious. HMOs also provide preventative care such as regular doctors'
visits, immunizations, well-baby checkups, mammograms, and physicals, plus other
services such as outpatient mental health care, which is provided only on a
limited basis. Most people like to use HMO plans as they do not require the
filing of any claim forms for hospital visits or stays. Members of the plan
simply pay via a membership card.
In nearly all HMO plans, you are either assigned or you choose a doctor to serve
as your primary care physician. This doctor monitors your health and provides
most of your medical care, referring you to specialists as and when needed. You
usually cannot see a specialist without a referral from your primary care
doctor; this is why HMO plans can limit your choice of physicians.
Point-of-Service Plans
Many HMO plans also offer a Point-of-Service plan. Here the primary care doctor
mainly refers you to other providers in the plan, but you also have a choice of
being referred outside the plan, and can still get some insurance coverage. This
means that if a doctor refers you to another specialist outside the insurer's
network, the plan will pay most or at least part of the bill.
Preferred Provider Organizations (PPOs) Plans
The PPO plan is a combination of a fee-of-service plan and an HMO plan. Here,
you have a limited number of doctors and hospitals to choose from; however, when
you do visit the doctor, you pay by membership card like in the HMO plan. With
this plan most of your bills are paid if you go to your network provided doctor.
The PPO plan is similar to an HMO plan because the PPO plan also requires you to
choose a primary health care provider to monitor your health. Most PPO plans
also receive preventative health care. You are allowed to visit a doctor outside
your PPO plan, but you will have to pay a larger portion of bill, while the
affordable health insurance company only covers a small part.
About the Author:
Insurance Expert - (
http://www.healthinsurancedepth.com) - Affordable Health
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