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Group Health Insurance
Health Maintenance Organizations (HMO)
Health maintenance organizations are prepaid health plans. As an HMO member, you pay a monthly premium. In exchange, the HMO provides comprehensive care for you and your family, including doctors' visits, hospital stays, emergency care, surgery, lab tests, x-rays, and therapy.
Preferred Provider Organizations (PPO)
The preferred provider organization is a combination of traditional fee-for-service and an HMO. Like an HMO, there are a limited number of doctors and hospitals to choose from. When you use those providers (sometimes called "preferred" providers, other times called "network" providers), most of your medical bills are covered.
Point of Service Plan (POS)
A Point of Service plan offers participants the option to choose the type of coverage they want before each medical service. It combines elements of an HMO (requiring a primary care doctor) and a PPO (the ability to receive services out-of-network and still have coverage at a reduced rate). If your PCP does not provide or coordinate your care, this choice pays lower benefits.
Fee for Service or Indemnity Plans
Coverage in which the insurance carrier reimburses the insured person for medical expenses after care has been given. The choice of physician and hospital is usually completely up to the patient; there are deductibles and plans that usually specify a maximum amount that will be paid for covered services.
Health maintenance organizations are prepaid health plans. As an HMO member, you pay a monthly premium. In exchange, the HMO provides comprehensive care for you and your family, including doctors' visits, hospital stays, emergency care, surgery, lab tests, x-rays, and therapy.
Preferred Provider Organizations (PPO)
The preferred provider organization is a combination of traditional fee-for-service and an HMO. Like an HMO, there are a limited number of doctors and hospitals to choose from. When you use those providers (sometimes called "preferred" providers, other times called "network" providers), most of your medical bills are covered.
Point of Service Plan (POS)
A Point of Service plan offers participants the option to choose the type of coverage they want before each medical service. It combines elements of an HMO (requiring a primary care doctor) and a PPO (the ability to receive services out-of-network and still have coverage at a reduced rate). If your PCP does not provide or coordinate your care, this choice pays lower benefits.
Fee for Service or Indemnity Plans
Coverage in which the insurance carrier reimburses the insured person for medical expenses after care has been given. The choice of physician and hospital is usually completely up to the patient; there are deductibles and plans that usually specify a maximum amount that will be paid for covered services.