Health insurance is a complicated game, and it seems every provider has something bigger andbetter to offer at a more competitive rate. From preferred provider organization plans, which allow employees to choose from a preferred network of medical professionals, to supplemental health insurance for seniors with Medicare, here is the ultimate guide to help you pick the right package for you.
Preferred Provider Organisation (PPO)
A PPO plan allows the employees involved to use an exclusive network of doctors and hospitals and will have flexibility within this to pick the healthcare professional who can best meet their needs. This gives more power to employees, providing a greater choice of provider with the bonus of lower premiums.
Health Maintenance Organisation (HMO) Health Insurance Plans
An HMO is a group policy which offers a low-cost solution to your health insurance concerns. Premiums are low, and there is a broad range of preventative services available such as immunizations and checkups. The lower cost does come with a price; you will have less choice over the physicians and hospitals you have to choose from.
Point of Service (POS) Health Insurance Plans
A POS plan allows you to combine many of the features of PPO and HMO plans. Employees will choose a primary care physician from the network providers options, and any services referred by this primary care physician will equip the employee with a higher level of coverage. One of the downsides is that many costs may have to be paid upfront and the cost reimbursed.
Exclusive Provider Organisation (EPO) Health Insurance Plans
An EPO will work in a similar way to an HMO, offering a select, predetermined network of physicians to choose from. A professional must be selected from these options, except in the case of emergency, when an alternative may be sought. The employee will have a primary care physician who is responsible for referrals to specialists within the network where required allowing the policyholder always to have access to high-quality care. The lower, more affordable rates offset the lack of choice.
Indemnity Health Insurance Plans
An indemnity health insurance plan is also known as a fee-for-service plan. Predetermined amounts, or specific percentages of costs, are paid directly to the member for the services covered. The member may then be responsible for any deductibles or coinsurance amounts. This requires the member to pay an upfront cost, and a claim will need to be filed to ensure reimbursement. This plan also allows for high levels of flexibility when it comes to choosing a hospital or a medical professional.
Health Savings Account (HSA) Health Insurance Plan
HSA plans are a popular alternative which offer a combination of a tax-favored savings account and a high-deductible health plan to cover any medical expenses. These are usually owned by employees, and it is up to the small business to contribute, whether they are part of a group policy or not. Contributions are made pre-tax, and any unused funds will roll over to the following year and accrue interest, all tax-free.
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