Health Insurance 101 Explained

We all understand the importance of healthas well as a possible larger selection of physicians
insurance; however, as the types of healththat might be available with a HMO. Out of
insurance continue to increase it is becoming morenetwork services may also be covered; however,
and more difficult to select the type of coveragefor a higher charge than in network services.
that is best for you and your family. To help youA POS, or Point of Service, is also similar to a
find out which type of policy might benefit youHMO in that you select a primary care physician.
the most, let's take a look at the most commonThe difference is that you are free to choose out
types of policies.of network treatment if you're willing to pay a
There is usually a lot of hype regarding HMOs sohigher out of pocket cost. Â
let's look at that one first. A HMO is a healthAnother option is what is known as a traditional
maintenance organization plan that works with acoverage policy. This type of policy will have a
specified group of doctors and hospitals within thehigher monthly premium as well as deductibles. In
network. A primary healthcare physician isaddition, you will generally be required to pay for
selected and you must obtain referrals for careservices out of your own pocket up front and
that cannot be provided by that physician. Thethen submit claim reimbursement forms.
benefits of this type of plan are lower office visitYou may also wish to consider various types of
costs and prescription drug co-pays. In addition,disability plans, which cover a percentage of your
there will typically be either no or limited deductibleincome in the event that you experience an illness
costs for hospital stays. Depending on youror accident that prevents you from working for a
coverage, there may also be no pre-existingperiod of time. A short term disability plan will
condition cause limitations. It is also important toprovide benefits from the first day of an accident
understand that your choice of doctors andor the eighth day of an illness up to 26 weeks.
hospitals will be limited with a HMO and you won'tGenerally, this type of plan will cover 66% of
be able to have out of network services covered.your weekly income.
A PPO or Preferred Provider Organization worksLong term disability will begin after short term
similar to a HMO; however, the major differencecoverage has expired and will provide coverage
is that you are not required to select a primaryfor a variable term, depending on the policy you
care physician. In addition to the benefit of beingselect. Some policies are limited to providing
free to choose your own physician withoutcoverage up to two years while others will cover
worrying about a referral you also gain the benefityou up to the age of 65.
of limited or no deductible costs for hospital stays