Which health care plan is right for you and your family is determined primarily by cost and coverage.
When it is time to decide what type of health care plan is best for you and your family, your choices could be overwhelming. When considering a health care plan, the plan needs to meet the financial and health criteria of you and your family. The four major types of health care plans in the United States include health maintenance organizations, preferred provider organizations, fee-for-service and point of service.
Health Maintenance Organization (HMO)
An HMO is a managed health care plan that rations medical care in efforts to save medical costs. HMOs cover all necessary medical treatments and provide you and your family medical coverage with a fixed fee with no deductibles. You and your family are members of the HMO and you have the ability to choose a doctor in your health care plan. The doctor you select will be your primary health care provider who can refer you to other doctors and specialists within the organization if needed.
Preferred Provider Organization (PPO)
A PPO is another managed health care plan similar to an HMO. Unlike an HMO, however, you have the ability to select from a pool of doctors and specialists you would like to see, but the preferred provider organization encourages you to select doctors within the organization. A PPO has a large network of doctors who provide health care that costs less and for a specific fee.
Fee-for-Service Plan
A fee-for-service plan, also known as an indemnity plan, is the most expensive health care plan available. The fee-for-service plan gives you full control over which hospitals or doctors you use and enables you to change your doctor at any time. Most health care plans require patients to meet a deductible each year per routine visit. A deductible is the amount of money that you pay for yourself or per person for medical expenses before your insurance company begins paying fees for these services. After you reach your deductible, the plan pays a certain percentage of your hospital or doctor bill. The most common percentage arrangement is 80/20. The indemnity plan pays 80 percent and you pay the remaining 20 percent of the bill. Since this health care plan is the most expensive for families, is it not a popular selection for most Americans.
Point of Service (POS)
Point of service is a health care plan that combines a PPO and an HMO. Your primary health care provider will refer you to doctors, similar to an HMO. As with a PPO, choosing a doctor within the organization means your medical costs will be less than if you chose an outside doctor. Point of Service plans are not as expensive as a PPO, but cost more than an HMO.
Tags: care plan, health care, health care plan, health care, your family, within organization
