There are several types of health insurance plans available to Americans. However, some are more common than others. This is basically due to the coverage they offer, the costs involved, maximum lifetime benefits, deductibles, out-of-pocket expenses and, their ease of use, etc.
Health Maintenance Organizations (HMO)
The HMO is more or less a prepaid health plan where you pay monthly premiums. This type of plan provides comprehensive care by utilizing a contracted network of health care providers or its own providers. You usually have to visit a physician in the network unless it’s a medical emergency. Copayments are common each time you visit a physician or other health care provider. You also need to select a primary care physician (PCP) or one will be assigned to you. The PCP will refer you to a specialist if needed.
Point-of-Service (POS)
Many HMOs also come with an option known as point-of-service. The PCP will typically refer patients to other physicians in the network. However, they’re free to visit health care providers out of the network, but if you don’t have a referral there is a coinsurance fee.
Fee for service
This is also known as indemnity. Basically, you pay a specific fee every time you visit a health care provider or use a service. You’re free to see any doctor you please in the country as there are no networks involved. The insurance company pays part the fee with the patient paying the rest. Most of these plans are based on monthly premiums and come with yearly deductibles. They also usually have maximum limits for out-of-pocket expenses.
Preferred Provider Organizations (PPO)
This type of plan combines HMOs and fee-for-service plans. Patients are asked to visit providers which belong to a group known as preferred or network providers. Each visit and service used usually comes with a small copayment cost. In addition, coinsurance and deductibles could be in place. A PCP is required, but you can visit doctors outside of the network for an extra fee.
