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There are 5 main types of health insurance plans: PPOs, HMOs, POS's, Traditional
Plans, and HSA's.
Here are the definitions of each plan type:
Preferred Provider Organizations (PPOs)
Under this program, an insurance company enters into contracts with selected hospitals
and doctors to furnish services at discounted rates. As a member of a PPO, you might
be able to seek care from a doctor or hospital that is not a preferred provider,
but you will probably have to pay a higher deductible or co-insurance.
Health Maintenance Organizations (HMOs)
These organizations provide health care services directly to their members, who
pay a fixed monthly fee to the HMO. These services include such things as hospital
care, surgery and routine office visits. The HMO is an alternative to traditional
health insurance because it provides actual services rather than just reimbursement
for health care expenses. Enrollees usually pay a small co-payment for care or services
they receive.
Point of Service (POS)
Health care plan that allows enrollees to choose whether to receive a specific service
from a contracted preferred provider or a non-contracted provider. POS plans are
a combination or either an HMO or PPO plan with a traditional indemnity plan. For
the maximum level of benefits, the enrollee must consult their primary care physician
prior to obtaining treatment or services.
Indemnity (Traditional)
With this plan the health insurance company pays all or a portion of the bills after
services are received by the insured. Other characteristics of this kind of plan
include: 1) no connection between the insurance company and the people who provide
the health care; 2) no restrictions on the doctors or hospitals you must use to
receive the health care; 3) a deductible may have to be paid before the policy begins
to cover the expenses.
HSA (Health Savings Account)
A Health Savings Account is a tax-favored savings account, combined with a qualifying
high-deductible health insurance plan. This combination can provide:
Lower cost Major Medical Protection
Significant Premium Savings
Immediate Tax-savings
Long-Term Investment Vehicle
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