Whether you are seeking health insurance through your employer
or on your own you will be offered a variety of plans. In order
to make the proper decision about which plan is right for you it
is important to know the basic characteristics of the most
popular types of health insurance. After this it is wise to get
many quotes on health insurance and compare them. This is a free
way to compare plans and prices.
Fee for service
For many years the fee for service plan was very popular and
widely used type of health insurance. The insured pays a monthly
fee. A deductible is applied to the cost of the services. Some
services related to healthy living or emergency services may be
exempted from the deductible. Once the deductible has been met
the insured and the insurance company share the cost of
services. For most companies the split may be 80/20 or 70/30.
The company pays eighty or seventy percent, the insured pays
twenty or thirty percent. There will be a cap on the total
amount of money the insurance company will pay in a lifetime.
Health Maintenance Organization (HMO)
HMOs have become increasingly more common in the last decade.
Again, the insured pays a premium which makes him/her a member
of the HMO. As a member of the group the member is entitled to
visit any of the doctors who are part of the group. These
doctors may all work together in an HMO facility or may work in
individual clinics as part of a group of doctors under contract
to the HMO. Members may have to pay what is called co-pay when
they visit the doctor. No paperwork is necessary to validate the
claims of an HMO member; however, members may wait longer for
non-emergency appointments than they would with a fee for
service insurance program. An HMO generally requires its members
to have a primary care physician who then refers the member to a
specialist if needed.
Preferred Provide Organizations (PPO)
The PPO, a blend of the fee for service model and the HMO model,
is a fast growing sector of health insurance. As with an HMO
there is a network of doctors from which the insured chooses
his/her physician. This physician is responsible for designating
the need for specialized care. A co-payment will be required
when an office or hospital visit is made. There will also be a
deductible and medical expenses will be divided at an agreed
upon scale between the insured and the insurance company
operating the PPO. A person may choose to use a doctor who is
outside of the network. Expenses incurred for medical care
outside the network will make the patient's share higher.
Please collect as many quotes as possible in order to compare
services and rates. This is a free way to learn a lot about all
of your options.
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