Finding the right health insurance coverage for you and your family
is important because it will determine the doctors you can have,
the costs you'll have to pay, and the process you'll have to go
through in order to receive certain types of treatment. For this
reason, you need to understand the options that are available to
you.
Health Insurance Coverage Option 1: PPOs
PPOs (Preferred Provider Organizations) allow you to go to the
doctor of your choice, but you may end up paying more out-of-pocket
for doctors who are not part of the provider's network. For example,
if you see a family physician in the network, you may only have
to cover a co-payment of $10 to $20. On the other hand, if you visit
a doctor outside of the network, you may end up paying 50% or more
of the total bill yourself.
PPOs also have a deductible that you must meet before they will
begin paying your medical expenses. The co-payments count towards
your deductible. Once the deductible is met, you will still have
to pay a portion of your medical expenses based on the provisions
of your plan. For instance, many plans split the costs so you cover
10 or 20% of the expenses while the insurance picks up the other
80 to 90%. You can find more information about PPOs at the American
Association of Preferred Provider Organizations' web site.
Health Insurance Coverage Option 2: HMOs
HMOs (Health Maintenance Organizations) are often a more affordable
heath insurance coverage option but you sacrifice flexibility for
added savings. HMOs work with only a small number of medical professionals,
and you must use those professionals if you want the costs to be
covered by your insurance. Additionally, you must select a primary
care physician from the network. For any medical problem you have,
this physician is your first contact. He or she will then have to
refer you to another professional in your HMO network before your
insurance will cover the costs.
On the positive side, HMOs don't require you to fill out paperwork
regarding your insurance claims. Plus, you don't have to worry about
deductibles or splitting your medical costs with the provider either.
The majority of HMOs do not contain either of these provisions.
However, most HMO health insurance coverage does require you to
make co-payments which are generally $10 to $20 per visit. You can
learn more HMOs by visiting the New
York Consumer Guide to HMOs.
Other Health Insurance Coverage Options
If you're between health insurance programs or are unsure of what
type of program to choose, you may want to opt for temporary
health insurance.
Health Insurance Coverage Resources and References
