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