Life Articles

Having at least major medical health insurance coverage is appropriately regarded as being a basic necessity in our risky world. Even if you can sidestep any unplanned serious health issues, it's essential to back up a healthy life with recommended checkups. Following is a short discussion of the various categories of major medical health insurance plans that are generally offered to equip consumers with good physical health.

Health Maintenance Organizations (HMOs)

Health Maintenance Organizations, or HMOs, are major health insurance plans in which you are charged a monthly premium. Consumers who opt to to enroll in HMOs must pick a primary care physician from an existing group list of physicians employed by the HMO and the same is true of hospital choices offered. To this end, you may lose a long-standing connection with your family doctor simply because they do not work for the HMO network.

Preferred Provider Organizations (PPOs)

Preferred Provider Organizations, or PPOs, are major medical insurance programs which permit patients to choose any doctors they would like. However, certain physicians that are within the insurance companies' network will accept discounted payments in exchange for services. If you go out of network for service, you still have the benefits, but they cost you more out of pocket. Therefore, most of those who depend on PPOs for their major health insurance services are willing to be cared for exclusively by network member doctors and specialists. Some patients may find it worthwhile to have this greater discretion, but it typically comes with a higher cost.

Point Of Service Plans (POS)

Point of service plans, or POS plans, are a hybrid form of Health Maintenance Organization. One of the chief differences between HMOs and this form of major health insurance is that the latter plan allows you to control which medical professionals to have access to as opposed to requiring recommendations from your primary care doctor. However, you may encounter differing levels of coverage if you decide to seek the services of a specialist outside of the plan without such a referral.

Fee For Service Plans (FFS or Indemnity)

Fee For Service (FFS), or Indemnity, insurance plans are the least restrictive major medical insurance policies to a degree. As the patient, you can go wherever you want of your choice for treatment. The health care provider then bills the insurance carrier who in turn pays all or a pre-arranged portion of the total balance pending, although the patient is sometimes also billed when the carrier does not pay in a timely manner or pay the all the charges.