Health Insurance Articles
Finding The Right Group Health Insurance Plan For You
2010-11-05
Group health insurance provides quality health insurance at an affordable rate. Everyone has different healthcare needs, so most group health insurance providers offer health insurance options. The most common health insurance options are fee-for-service, Health Maintenance Organizations, Point-of-Service and Preferred Provider Organizations. It is important to choose the right group health insurance plan for your specific needs.
Members of fee-for-service, or indemnity, plans pay a monthly premium and are free to visit any physician or other type of healthcare provider they choose. Members pay for healthcare services at the time of the visit, and the insurance company reimburses the member a percentage of the fee after the member submits the proper paperwork. Members also pay a deductible, which is the annual dollar amount that you must pay before the insurance coverage begins.
A health maintenance organization, or HMO, is another type of health insurance option. Members pay a monthly premium and choose a primary care physician (PCP) from a list of physicians who are in the HMO network. The member sees this physician for all healthcare needs. If a specialist is required, the PCP must provide a referral, and the specialist must be in the HMO network for the visit to be covered by the insurance. Most HMOs do not require a deductible and copayments are less than other health insurance options. A copayment is a fixed amount you pay every time you use a certain service, such as $20 for every visit to your PCP.
A PPO is a preferred provider organization, and members pay a monthly premium. A PCP is not required, but members are encouraged to see healthcare providers that are within the PPO network. PPO members have the option of using providers outside the plan's network; however, the coverage is at a higher expense to the member. A yearly deductible is required and the copayments are generally higher than those of HMOs.
A point-of-service plan, or POS, is another health insurance option. They are considered a hybrid plan because they combine aspects of HMOs and PPOs. Members pay a monthly premium and must choose a PCP from the physicians within the plan's network. However, if a member chooses to see a healthcare provider who is not in the network, they are still covered by the insurance. The member incurs a higher out-of-pocket expense with an outside provider, but the member still has that option. Unlike PPOs, members have no deductibles and limited copayments when they use network providers.
Which group health insurance plan you choose depends on your personal healthcare needs. Most group health insurance providers offer health insurance options that allow their members to find the right plan to fit their life.
