Family Health Insurance, Plans and Policies

What is Health Insurance - PPO, HMO?


Family health insurance and plans
The categories for health insurance are generally considered to be "traditional" and "managed care". Within those categories, there are four basic types of plans which include (a). POS, or Point-Of-Service plans; (b). PPO, or Preferred Provider Organizations; (c). Traditional indemnity plans, which are now often called fee-for-service plans; (d). HMOs, or Health Maintenance Organizations. When you make health insurance comparisons, you'll find that one of these categories best suits your health insurance needs. The flexibility of fee-for-service suits some people, whereas other people are drawn to the generally lower rates for managed care health insurance plans.

Buying health insurance is complicated. You'll face dizzying choices as regards policy choices and the many payment plans offered by the health insurance companies. Your choice of plans and payments will directly influence the type of care and coverage that you obtain. Despite repeated attempts to "nationalize" health care, as in the 1990s Clinton presidency, no one guaranteed universal care plan exists. Regulations grow daily. Overheads and insurance liability costs for practitioners increase astronomically, all increases eventually flowing to you, the consumer, as you see annual coverage rates increase as much as 12% per annum.

An unforeseen and uninsured medical expense can wipe out a family's assets in a heart beat. Thus, most people need not only the health insurance for health sake, but also for financial sake. The simplest medical procedure or a brief hospital stay can easily cost $20,000 or more.

Health insurance plans are mostly delivered through medical insurance coverage acquired by employers on behalf of their employees in the form of group health insurance. There is no typical group health insurance plan due to the innumerable variations of plans and options and pricing as offered by health insurance companies. Due to increasing medical costs under the traditional indemnity system, in recent years many employers have sought cost-effective ways to finance care for their employees. This trend resulted in funding commitment towards managed care plans, which attempt to manage more efficient use of medical services as a management discipline to contain treatment costs.

The two major types of managed care systems are preferred provider organizations or PPOs and health maintenance organizations or HMOs. These health care management companies contract with physicians and medical facilities in an effort to supervise decisions authorizing care quality and costs. Similarly, both PPOs and HMOs create financial incentives for subscribers to use the contracted physicians and facilities and require providers to bear some financial risk for care.

In contrast to HMOs, PPOs health insurance plans permit you to use primary care providers outside the PPO network. You are given financial incentives to use doctors registered in the preferred group, however. These PPOs health insurance plans include small or no deductibles and lower coinsurance payments. PPOs health insurance plans are contractual arrangements that provide services at a discount to a volume group of patients. Unlike HMOs, which are prepaid systems, PPO providers operate on a fee-for-service basis, similar to traditional indemnity arrangements. The rates, however, have been pre-negotiated between the PPO provider and parties such as employers, unions, and insurance companies. In return for their discounted rates, the "preferred" group of doctors is guaranteed a specific volume of patients.

When assessing health insurance plans offered by a PPO or an HMO make sure that your health insurance quote provides disclosures about the plan's policy towards pre-existing condition, in particular whether the coverage plan requires specific minimum waiting periods before benefits accrue. Next, do you best to determine whether the health insurance plan states clearly what your out of pocket expenses are for each plan model. As you dig deeper, ask what the health insurance plan rate increases have been over, say the past 10 years. Is this health insurance company financially stable?

Health insurance in the United State continues to be competitive, especially as it is today if applying online over the Internet. Guide4Home hopes to help you find the right health insurance coverage for your needs and circumstances. You not only save money, but you also get a wide range of choices from the health insurance brokers we recommend on this site who offer this instant facility. Health insurance policies will be exactly the same as you'd obtain from the local representative office of any of the major health insurance companies you wish to take your policy with. By doing the research yourself online you might well save up to 40% of the commissions normally paid to the agents.

 

 

 

 

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