Medical Insurance Plans

Not all Plans Are Built alike

One of the first things you will notice when shopping for insurance for your family is that there is a wide array of types of insurance in the country to meet your needs. Telling the difference between these various plans can have a huge difference in your medical insurance future. So what do each of these plans mean?

HMO

Health Maintenance Organization. A form of health insurance combining a range of coverage in a group basis. A group of doctors and other medical professionals offer care through the HMO for a flat monthly rate with no deductibles. However, only visits to professionals within the HMO network are covered by the policy. All visits, prescriptions and other care must be cleared by the HMO in order to be covered. A primary physician within the HMO handles referrals.

PPO

Preferred Provider Organization. A health care organization composed of physicians, hospitals, or other providers which provides health care services at a reduced fee. A PPO is similar to an HMO, but care is paid for as it is received instead of in advance in the form of a scheduled fee. PPOs may also offer more flexibility by allowing for visits to out-of-network professionals at a greater expense to the policy holder. Visits within the network require only the payment of a small fee. There is often a deductible for out-of-network expenses and a higher co-payment. A policy holder will have a primary physician within the network who will handle referrals to specialists that will be covered by the PPO. After any visit, the policy holder must submit a claim, and will be reimbursed for the visit minus his/her co-payment.

HSA

Health Saving Account: An account that allows individuals to pay for current health expenses and save for future qualified medical and retiree health expenses on a tax free basis. HSAs allow employers and/or employees to contribute to a tax-deferred personal savings account which is used to pay smaller and routine medical expenses. HSAs must be linked to a high-deductible health insurance policy with a minimum $1,000 deducible for an individual or $2,000 for a family.

View Medical Insurance FAQs for a list of answers to the most common questions asked about medical insurance.