Health Insurance Providers 101

Written By: Arnold Casey on September 22, 2010 No Comment

There usually is a health plan given to employees by their respective employers. This is either from an HMO, Health Maintenance Organization or a PPO, Preferred Provider Organization. People can also avail from a POS or a Point of service plan. This article will give you an idea about HMOs and PPOs that will certainly give you help when choosing your health insurance.

If you are enrolled in a Health Maintenance Organization then all of your health needs will be serviced by one provider. You can choose from a huge number of hospitals, laboratories, clinics and pharmacies in this network. You also need to choose a PCP or a Primary Care Physician who will be responsible for managing and coordinating all of your health care. A referral is needed from your PCP whenever you need to consult a specialist based in another hospital or clinic that is part of the network.

Now, when you are enrolled in a PPO or a Preferred Provider Organization you do not need to have a PCP. You have the freedom to choose your own doctor in any hospital just as long as it is accredited by the organization. All you need to pay is the annual deductible plus no referrals are required. Going to a non-accredited hospital or clinic will of course have you paying more.

For payments in HMOs you will only need to pay for your prescriptions, doctor visits and procedures. Of course you need to pay your monthly fees together with your employer. There are some PPOs though which has an option for an annual deductible for services that you have to avail of outside of the network. It is great that PPOs can reimburse any health expenses as long as you have an official receipt from the said hospital. HMOs do not have option like this one so you have to go to an accredited hospital for your treatment.

These are the basic facts that you should know about when choosing between HMOs and PPOs for your health care. Make sure that you choose a health care provider that will benefit you more and be suited to your health care needs.

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