No, but in-network care is less expensive Lower out-of-pocket costs and a primary doctor who coordinates your care for you, but less freedom to choose providers Your PCP will coordinate your specialist care.Ĭross-eyed yet? To clear things up, we summarized all the features we just discussed in the handy table below.ĭo you have to stay in network to get coverage?ĭo procedures and specialists require a referral? Pros: You’ll find more provider options to choose from. POSs do provide some coverage for seeing an out-of-network provider, and your PCP will coordinate the care. Most services require pre-authorization from the insurance company.ĭespite what the acronym suggests, this is a pretty good plan.Ī point-of-service plan combines the features of HMOs and PPOs by providing different benefits based on whether you use in-network or out-of-network providers. Plus, there’s no need for a PCP referral to see a specialist.Ĭons: You’re limited by a smaller network of healthcare providers. Sound appealing? This might be the right network plan for you if you want the freedom to see specialists without a referral and you don’t mind being limited to healthcare providers in your network. Unlike HMOs however, EPOs do not require a primary care physician (PCP) referral to see a specialist.
#Compare medical insurance pro
Ready for another acronym? An exclusive provider organization is another type of managed care plan (like an HMO) where services are only covered if you use doctors, specialists or hospitals in the plan’s network (except in emergencies).ĭo you have the right health insurance coverage? Connect with a Trusted pro today. When it comes to choosing providers, it’s like what your teacher told you in preschool: You get what you get, and you don’t get upset. Pro: Lower out-of-pocket expenses make HMOs attractive.Ĭon: There’s not much flexibility. Your healthcare coverage will be defined either by where you live or where you work. Another restriction: HMOs often work only in a specific geographic area. 3 So unless there’s an emergency, your plan will not pay for out-of-network care. Just be sure you know which providers accept your plan before getting any treatment so there are no surprises.Ĭon: Higher premiums make PPOs more expensive than other types of plans like HMOs.Ī health maintenance organization is a health insurance plan that usually only covers care from doctors who work for (or contract with) that specific plan. Pro: Most PPOs have a decent selection of providers to choose from in your area. These plans are the most popular for people who get their health insurance through work, with 47% of covered workers enrolled in a PPO. (See what we did there?) Emergency care is often the exception to the rule. You’ll pay more out of pocket-often a lot more-than if you see the plan’s preferred providers.
PPOs also have coverage for doctors outside of their networks, but there’s a catch for the flexibility. These are health plans that contract with hospitals and doctors to create a network of (you guessed it) preferred providers. Preferred provider organization-the words get longer as the name unfolds! Let’s just say PPO.
#Compare medical insurance how to
If your company doesn’t offer a health plan or if you’re self-employed, we’re here to explain how to compare health insurance plans “in the wild.” Let’s go over the main types of available plan networks: They should be able to explain how to choose between the health insurance options you have at work. Well, consider this your health insurance map and cheat sheet all-in-one, because we’re going to take you through the various types of plans and how they work!įirst, if you have a job with an employer who provides health insurance, talk to your workplace health insurance administrator. It’s like trying to do sudoku on the subway-confusing and just a little scary.
#Compare medical insurance full
Health insurance is full of weird jargon and acronyms.
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