See..the HMOs and PPOs won't permit you to pick your preferred hospital or physician. In comparison, the indemnity policies would allow you to do so. They are the fee-for-service plans and hence offer you the option to pick your health care services. It would just cost you for the services through the life of your policy based on your policy specifications. Yupp, they could be a bit costlier at times ( as compared to the HMOs or PPOs) but you have a number of pay-back options. _________________ Register Now to have your Insurance queries solved.
You may need to pay for the deductible. Once you pay for this amount, then you'd be eligible to receive the benefits promised in your sign-up papers. If you have not defaulted on your health care charges...and then come across an event which has been promised to be covered under your policy, you're bound to have it. So, you pay your deductibles and you won't need to worry about the rest. Crossbreed _________________ Register Now to have your Insurance queries solved.
So, you pay your deductibles and you won't need to worry about the rest.
You may need to pay for a co-payment as well. This is that percentage of the associated expenses that you'd need to bear following the deductible.
If you have a 20% co-payment mentioned in your policy clauses...then you'd need to bear an amount equivalent of that percentage above your deductible. BarbieL _________________ Register Now to have your Insurance queries solved.
It really depends on what you're looking for. HMOs, PPOs and Major Medical (indemnity, reimbursement) plans are all different, and a lot of the purchase decision should be based on the factors affecting all three delivery systems.
HMOs and PPOs have networks. HMOs typically lock you into the network unless you have an emergency, get a referral out of the network from your primary care physician, or have purchased a special type of HMO called a Point of Service Plan/Option. You'll pay a "co-pay" at the time of service which can vary depending on the service and provider.
PPOs by their very nature allow non-network access; you don't need a referral from your primary care doctor to go outside of the network and still have coverage. The key is the Preferred Provider part- they're designed to encourage network usage by the participant. The participant saves money, sometimes considerable amounts, by staying in the network. Go outside the network, you're covered, but you'll pay more. Normally, network providers charge the enrollee a co-pay, similar to an HMO, while non-network providers can mean higher co-pays or even a deductible and co-insurance.
Major Medical policies are "any provider" plans. You can choose any licensed provider, generally within a geographical area (U.S. and Canada, for instance) and the insurer will pay. There are deductibles and co-insurance (not co-pays) for plan usage.
As you can see from this basic info, there are differences just in the very basic stuff. It really boils down to what you need, can afford, and prefer.
