The majority of Americans receive health coverage through private health insurance plans. These are plans offered by employers and other organizations. Public health insurance is offered by the government, and (theoretically) accessible to everyone in the country. Private health insurance is usually only available to employees and their families, and is often cheaper than public coverage because you are sharing the cost with the employer. There are two basic categories of private plans, with each individual plan varying in cost and benefits.
Managed Care Plans
With a managed care plan, you will be provided with a network of health care providers and facilities that are covered under the policy. These hospitals, doctors, specialists and pharmacists work together with the insurance provider to grant access to cheaper medical care. There are four kinds of managed care plans that you may have access to.
HMOs – An HMO (health maintenance organization) typically will have a lower premium (monthly payment). However, they only provide coverage for services rendered within their network. You are required to have a PCP (primary care physician) who can provide you with referrals when necessary.
PPOs – A PPO (preferred provider organization) will offer significantly reduced price health care from providers within their network; however, there is also some coverage for care provided outside of the network. You are not required to have a PCP and are granted a bit more freedom in choosing where you receive your health care.
EPOs – An EPO (exclusive provider organization) functions similarly to a PPO, except that there is no coverage on care provided outside of the network.
POS – A POS (point-of-service) plan operates as a combination of a HMO and PPO. You are required to choose a PCP that will manage your health care within the network; however, you do have the option to choose care provided outside of the network. The plan will cover a higher percent of services rendered within the network than without.
An indemnity plan pays for a certain percent of each service imparted by a health care provider. You have total freedom when it comes to choosing doctors, hospitals, specialists, etc. However, typically you must pay a certain amount (a deductible) yourself before the plan starts reimbursing you.
Here at McKnight & McKnight Insurance, our expert agents will help save you time and money by finding the perfect plan for you and your family. A quick phone call or web conference from the comfort of your home is all it takes for us to address your insurance needs. Call us today at (813) 792-2301