Health insurance can be confusing, if not downright frustrating. There are so many options, including premiums, copays, deductibles, types of coverage and more.
Hopefully, the major healthcare terms that we outline below will help. But, our licensed agents are ready and willing to answer any questions that you might have. We give you coverage, not quotes.
Perferred Provider Organization plans, commonly known as PPOs, are a popular healthcare plan option. PPO plans have built a network of healthcare providers that accept your insurance. You are still able to visit providers who work outside of the network, but you’ll have less coverage support with them.
A noticeable advantage to PPO plans is that you don’t have to be referred to a specialist. As long as the provider is in the network, you can schedule an appointment and be covered.
With a Health Maintenance Organization, or HMO, you’ll have a very broad list of providers to choose from. You’ll pick a primary care physician who’ll handle most of your healthcare needs and refer you to specialists as needed.
HMOs often, but not always, have a lower monthly premium and they also offer preventive care services. HMOs also often have no deductible and cap the amount of out-of-pocket expenses that you pay.
Exclusive Provider Organizations, also known as EPOs, only offer coverage from providers who are inside their network. Any out-of-network healthcare costs are yours to pay.
So, for example, an EPO plan might not work for you if their network wasn’t national and you planned to travel extensively.
POS plans, or Point of Service, take some parts from HMOs and some from PPOs. You’ll define a primary care doctor, but still have some coverage for out-of-network care or care that isn’t authorized by your primary care physician.
A POS plan might be a great fit, if your current physician is already a member of the network.
Also known as “fee for service” plans, indemnity plans allow you to see any provider you wish, any time you want. You have complete freedom to choose any doctor.
Indemnity plans usually have a deductible that you must meet before they start paying for your healthcare and they will pay your costs based on a set percentage of care cost that is known as the UCR, or usual, customary and reasonable.
Within each of these options, there are lots of additional choices. By reaching out to our licensed agents, you take the guesswork out of the process of choosing a healthcare plan. Our agents take the time to understand your life and lifestyle, then build a customized healthcare plan that’s a perfect fit for your wallet and your life.
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