Health Insurance - Indemnity & Managed Care
Choosing a quality health insurance policy can be a difficult task, but one that can be made easier by education and research. There are many plans available today to choose from, as well as many cost options.
The two (2) categories of health insurance plans are: Indemnity Plans – This plan enables you to make the choice as to your medical provider. Your medical bills are sent to your health insurance company. They pay their portion and you pay your part. Often Indemnity plans have a deductible, meaning there is a set amount stipulated that you pay before the insurance company covers your medical expenses.
Managed Care Plans – This health insurance includes three (3) different plans.
Preferred Provider Organization (PPO) – PPO are the most similar to Indemnity Plans. You have a network of doctors with whom you pay a portion of the medical expenses for treatment, called co-pay, and the insurance company pays the remainder for covered treatment. You are able to see doctors that are not part of the network, but it will cost you more for the services.
Point-of Service (POS) – POS allows the treating physician to refer you, as a patient, to other physicians within the POS plan. The physician is able to also make referral to doctors outside the POS plan, with the health care insurance covering the recommended treatment.
Health Maintenance Organization (HMO) – An HMO plan provide you, as the policyholder, a list of physicians (in-network doctors). You are able to select a treating physician from this HMO medical group. When receiving treatment, there is either a no co-payment or small co-pay. If your need to see a specialist, you are must contact your treating physician (primary care doctor) for a recommendation. If you do not do so, or see another doctor that is not part of the HMO plan, you will be responsible for all expenses incurred.