Health insurance cover is a type of insurance that usually covers the cost of surgical and even medical expenses that are incurred by a patient. It is always set as a deal between the individual and the company since the individual has to pay some expenses to the company and the company in return is set to pay the expenses at the hospital and even the bills. Many types of health services are covered by the insurance cover and some of these services include; visiting the doctor, prescription drugs, hospitalization, and even medical procedures. Through health insurance, one can benefit a lot from it. Some of these benefits include; access to necessary medical care, usually have medical protection, there are prevention and wellness services and even it gives one peace of mind.
One may worry about how he or she is going to obtain health insurance coverage. There are many procedures to obtain health insurance such as through an employer, the help of a program which is propelled by a government or even an individual can purchase directly from an insurance company. Health insurance covers most people and even continents in the world, for instance, health insurance for Americans.
Hereby are some of the prime types of health insurance that one needs to know.
1. Health maintenance organization
HMO is one of the types of health insurance coverage which usually provides medical services to customers which are comprehensive and the members are set to pay a monthly fee for their services. HMOs are usually designed to control the cost for the members by requiring them to choose a primary care physician whose responsibility is managing their care and even referring the members to specialists within the network of the HMO. This type of health insurance typically offers a wide range of services concerning medicine. Examples of these medical services include hospitalization, medical procedures, and even prescription drugs. It is also associated with the program where it creates awareness to the members concerning how to manage the chronic conditions and even on how to stay healthy. HMO health insurance is always less expensive for instance for people who don’t require continuous medical care.
2. Preferred provider organization
It is classified as another type of health insurance. It usually offers more flexibility and even choice. PPO always gives a chance for one to choose a health provider which includes the hospitals and the doctors, without necessarily having a referral from a primary care physician. There are networks of providers who are preferred and they have accepted to give services to the members of the plan with a discount. In this plan, you may choose to receive care from providers who are outside the network in conditions that you have to pay some higher cost out of pocket. PPO is associated with a lot of advantages such as flexibility. Through this plan, you may see a specialist without necessarily having a referral. It may favor mostly when one has a health condition at a chronic stage or when one needs special care.
3. Exclusive provider organization
Exclusive provider organization is a type of health insurance that is managed, and the insurance company usually contracts with a network of health care providers that includes the hospitals and even the doctors who are meant to provide services to members at rates with a discount. EPO generally covers care which is from in-network providers. They offer lower premiums and even one does not need to be in the pocket for the services. In EPO members are usually provided with a physician who takes care of them at the primary level and acts as the main point of contact when one needs a medical need. The primary physician also refers members to a specialist in case he or she is required through an in-network. EPO can be of benefit to individuals who do not require a lot of flexibility in choosing a health care provider.
4. Point of service plans
Point-of-service plans are usually a type of health insurance that contains a combination of HMO and PPO plan features. In this, members have free will to choose a physician in primary care who at most times are from health care providers. In PSO plans, members have permission to see out-of-network providers but with a cost that is a bit high. Members are at most times referred to a specialist in case they need to see a primary care physician but they will be required to pay some additional cost. Typically, PSOs have premiums that are high than the HMOs but slightly lower than the PPOs. In a business, POS may be a good option if your employees need flexibility even when choosing other network providers.
5. Indemnity plans
Another type of health insurance coverage is indemnity plans. It is also known as a fee-for-service plan. With this type of insurance coverage, the insurance company usually pays some fee which is average in a given area or even for a specified service but the person who is insured is required to pay the rest amount of the money. In this plan, the patient has no limitations about the network care provider hence meaning that the patients have the free will to choose the best hospitals and doctors that will suit them. Concerning this, the medical fees are usually defined from above by the providers hence giving variation from different physicians. Employees most time can consult a specialist without necessarily needing to have a referral or even when they don’t want to specify to one facility or physician at a primary level.
In conclusion, health insurance is of great benefit to an individual and there are many types of health insurance that one can benefit from. The article has discussed some of these types of insurance coverage which includes; health maintenance organization, exclusive provider organization, preferred provider organization, and even point-of-service plans. It is of great importance to have a keen review of every type of health insurance for one to determine the best insurance that best fits the needs of the individual based on the budget. Factors like flexibility and the network of healthcare providers may be considered for one to make an informed decision.