Health insurance plans are typically health care plans that provide coverage for health care expenses that you might incur in the future. Health insurance plans are usually purchased by an individual person, but they can also be purchased by an employer for their employees. Most insurance companies have a wide range of health care plans for both men and women.
Health care plans also sometimes referred to as medical care coverage. Benefits refer to health care coverage, prescription drugs, doctor visits, hospitalization, emergency medical care, and other health care services or items that are provided by your health plan. A comprehensive list of health care services or items covered by your health care plan.
Most health care plans are either HMOs or PPOs. HMOs, or health maintenance organizations, are similar to health maintenance organizations (HMOs), except with less restrictive rates and more flexible membership eligibility criteria. Participants in an HMO program may be required to designate a primary care practitioner (PCP). The PCP is usually a hospital, doctor, or clinic that participating in the HMO’s network. A wide range of health care providers may be covered by an HMO. HMOs usually have a monthly inflation rate on health care service charges.
PPOs or preferred provider organizations are similar to traditional health plans, except they allow more freedom of choice in physician settings and much greater freedom of choice in medical treatments and hospital settings. Participants in a PPO program may use any physician in their network at any point within the plan’s term limits. The physician’s primary care physician may also referrals to specialists. In some PPO plans, there is no co-pays or deductibles for physicians’ services. There is also a very narrow range of elective procedures and doctors can refuse treatment for non-essential health conditions.
Catastrophic Plans is usually offered through a hospital or medical group. Participants must designate a primary payer, usually their employers, that contributes to the cost of their health coverage. If they become ill or injured, they will be able to get coverage from this payer, along with any other benefits that the policy covers. Catastrophic plans provide “last chance” coverage in the event that you need emergency care or hospitalization services.
High Deductible Health Insurance Plan participants may be able to get partial or comprehensive “catastrophic” coverage. These plans often have a very low premium but you will have to pay a higher deductible for each visit to a doctor. In order to stay within the payment umbrella, a lot of health insurance participants elect to pay the deductible while using the doctors’ service. If you do this, be sure to read the fine print. Some insurers will allow you to pay the deductible and use the doctors’ service at a reduced cost. The coverage may help if you have an extreme medical condition or have expensive health issues.
Managed Care Plans, also known as health maintenance organizations (HMO), is managed health care plans that provide primary care physicians and hospitals within a network. Participating providers have been established by an HMO provider network, which can include local hospitals, out-of-network specialists, and nursing homes. Many managed care plans offer coverage for preventive care, which can sometimes save more money. Participating providers have been carefully selected to provide the highest quality care at the lowest cost.
Another type of managed long-term care insurance is a Preferred Provider Network (PPN). With a PPN program, people choose their own primary care physician, but are still required to use the services offered by the network. As in a PPO, once you visit a specialist, you will be billed. However, with a PPN program you are not required to pay the deductible or co-pay, unless you go outside of the network. These types of plans are generally less expensive than traditional health care plans.