Insurance - Head Matters

print

4. Health Insurance

a. Types of health insurance (continued)


Managed Care Plans are another type of health insurance. There a several kinds of managed care plans.

  1. Health Maintenance Organizations (HMOs) offer you an extensive network of participating physicians, hospitals and other health care professionals and facilities. You choose a primary care doctor from a list provided by the HMO and this doctor coordinates your health care. You must contact your primary care doctor to be referred to a specialist. Generally, you pay fewer out-of-pocket expenses with an HMO, but you are often charged a fee or co-payment for services such as doctor visits or prescriptions.
  2. Point-of-Service (POS) plans are where primary care doctors in the POS plan usually make referrals to other providers within the plan. If a doctor makes a referral out of the plan, the plan pays all or most of the bill. However, if you refer yourself to an outside provider without referral from your primary care doctor, the service may be covered by the plan, but you will be required to pay co-insurance .
  3. Preferred Provider Organizations (PPO) charge on a fee-for-service  basis. The participating doctors, hospitals and health care providers are paid by the insurer on a negotiated, discounted fee schedule. Costs are lower if you use in-network healthcare services, but you have the option of going out-of-network. If you choose an out-of-network provider, you are generally required to pay the difference between what the provider charges and what the plan pays.

Current Course:
Insurance

Adobe Flash Player Required

Get Adobe Flash player
Sign In to track your progress.

my toolbox

Groups
Close

Please sign in

In order to save a page/activity in either your toolbox or favorites you must first be logged in.