HMO health insurance plans

Health Maintenance Organizations (also widely referred to as HMOs) is a variation of health benefits distribution, which provides coverage on a fee-for-service basis. Insurance companies that provide HMO coverage plans each have an agreement with certain medical facilities and professionals in order to offer reduced fees to those, who purchase such plans.

What HMO plans are all about?

HMO plans are based around primary care physicians (PCPs) that a person buying such a plan has to choose from the network of medical providers the company works with. The PCP is the person who will manage and coordinate all the actions and services provided to the customer, as well as offer consulting and basic care measures such as check ups and exams. Preventive medical services are usually free of copayments within HMO plans.

In case the health problem of a person exceeds the professional field of knowledge of the PCP, the doctor refers this patient to another physician specialized in that very domain. The said specialist will further investigate the problem and use his expertise to resolve it, but only after he or she receives the referral from the PCP. Otherwise, you won't be able to receive any medical attention with the exception of situations of critical emergency when the risk of complications is very high.

The coverage you receive through an HMO plan is provided only within the limits of the medical network specified by your provider. In case the member of an HMO plan chooses to receive any medical services in a facility that doesn't make part of the network, there won't be any coverage and the person will cover all the expenses in full out of own pocket. Besides, HMO plans will allow you to receive medical care from an additional specialist only when you have the corresponding referral provided by your PCP. Otherwise, this is regarded as using out of network services and your expenses won't be covered at all even if it's the same medical facility where your PCP is located.

Why would you want to choose an HMO health insurance plan?

HMOs represent the most affordable and cheap health insurance amongst managed care options. If comparing the rates of POS or PPO, HMOs offer lower premiums and fewer copayments. This is why many employees choose HMOs as the type of group insurance plans for their workers. This is especially useful for those, who rarely visit a doctor and don't need an extensive medical care with their plan or don't have pre-existing conditions that they want to cover. Employers find these plans useful because they can cut their costs and provide additional benefits to their workers rather than paying only for health insurance.

If you are worried by the constant trend of medical costs and insurance rates rising every year, it's highly recommended to see if an HMO plan meets your insurance requirements. Get health insurance quotes from multiple providers and you will definitely find a good plan for a reasonable and competitive price. However, if you have more specific insurance needs and can spend additional money on extensive coverage, it's better that you investigate other plan options outside HMOs.

Preferred Provider Organization health insurance possibilities

In case you are looking for a comprehensive type of health coverage with much room for flexibility that still has a reasonable price-tag, a PPO insurance plan may be just the thing you need to cover your health needs.

Preferred Provider Organizations represent a network of medical workers, facilities and other professionals that are contracted by the insurance company in order to get more competitive fees for their customers. So those who are getting their medical services within the specified network will be charged with lower rates than if looking for them outside. However, you can still receive medical coverage outside the network too, only that your rates will be higher compared to what you get within the network.

PPOs can be regarded as a mix of traditional indemnity health plans and later-developed managed care options. In what concerns the network organization of medical services, PPOs are quite similar to HMO insurance plans. However, when you get a PPO plan, you aren't required to choose a primary care provider (PCP). It's the main difference between these two quite similar health insurance plan types. And since there aren't any PCPs in PPO plans, you aren't required to provide a referral when addressing any given specialist within the network. And when you receive your medical care in a facility or with a specialist outside the specified network your copayments will be considerably higher, but you still will receive partial coverage.

The advantages of PPO plans:

• PPO plans help keeping out of pocket costs within certain annual limits.


• PPO plans let you consult with any medical service provider even if he or she doesn't make part of your network.


• PPO plans offer substantial money saving potential when receiving healthcare services within the specified network of doctors and facilities.

The disadvantages of PPO plans:

• PPO plans require you to pay the deductible before receiving any coverage.


• PPO plans make services you get outside the specified network a lot more expensive.


• PPO plans have higher copayment rates if compared to other managed plan types.

Flexibility has its price

As my may guess, when a plan provides more flexibility and options it will usually cost more than a cheap health insurance plan with greater restrictions. That's why PPOs are generally more expensive than HMOs.

Even in case you choose a lower amount of coverage with your PPO plan, there are additional fees and payments that will make your plan more expensive. So don't base your estimations on the amount of coverage alone.

For instance, besides the usual premiums you have to pay every month, there are also additional coinsurance fees, except for the cases when you use a preventive healthcare service. There is also a deductible to be paid before you can receive any benefits from your PPO plan.

How to get a good plan?

Sometimes it may be quite hard to get a good PPO plan that would provide increased flexibility for a reasonable price. If you feel that a PPO plan is just the thing you need to cover your medical costs, you first would want to get health insurance quotes from numerous providers or talk to your insurance agent about the options you have. Shopping around doesn't take much time but as a result you can expect substantial savings if you manage to select the right provider.

What does form the auto insurance rates?

Most of insurance buyers often forget that they are insuring a certain thing and it directly influences the final price of the policy. When speaking about auto insurance, the car you drive is the primary factor that affects your insurance costs and at certain moments the insurance company point of view of the car can be quite surprising to usual drivers. Insurance companies have internal charts and ratings, assessing how much it will cost you to insure any given car make or model. And the primary elements that set the car in this rating are the risk factor and the theft factor of this particular make and model. The risk factor relates to how the car will perform in an accident and how likely it is to end up in one, while the theft factor, eventually, deals with the likelihood of the vehicle to be stolen.

When a new car comes out, it is placed at a certain place within the rating as compared to other similar models and the insurance rates are set accordingly. And as experience with this particular model accumulates in the company's records, the model can be moved in either direction within the rating, making it cheaper or more expensive to insure. Of course, other things like your driving record and credit score also influence the cost of insuring your vehicle, but the car is actually the most important and crucial factor you will have to deal with.

In general, it will be more costly for you to insure sports cars, luxury cars and SUVs. Some companies rate SUVs differently because of their increased safety for the people inside, while others take in regard the fact that these vehicles are likely to cause more collision damage than others. Sports cars are much more likely to end up in a serious or even tragic accident due to their power and speed that is so tempting to be pushed to the limits. And luxury cars are usually the target of auto theft due to their price, and are more expensive to repair because of exclusive parts and costly service.

Car insurance experts state that the most attractive and non-expensive class of vehicles to insure are mid-class and middle sized cars. It is important that the car has good crash-test ratings and additional safety features installed, being safe in case of an accident. Small light-weight cars are cheaper to repair but they get damaged more easily and this may lead to serious injuries to those who are inside of it. The higher is the mass of your vehicle the less damage it will take in case of collision. That's why big SUVs are considered to be quite safe from this point of view.

It is good to see what car insurance rates you can get for different cars before you actually buy the auto. If the question of insurance price really concerns you then choose a vehicle that is cheaper to insure. And if the rates don't bother you much, just buy a car that you really like.

POS (Point of Service) health insurance benefits explained

When it comes to health coverage these days, we sure have a lot of various options to choose from. One of such options, which has become quite popular lately are Point Of Service (POS) plans that can be viewed as a mix of traditional indemnity and modern managed coverage options. And what such a combination provides you with are money saving potential and flexibility, all in a single package.

Health coverage on two levels at once

People familiar with HMO plans can easily see the similarity between HMOs and PPOs when it comes to organizing the services. Here you are also required to choose a PCP (Primary Care Physician), who will coordinate your services and provide referrals to other specialists within the network when required. But you are also free to choose any facility or physician that doesn't make a part of the specified network. And a POS plan will pay for such services out of the network, however to a narrower extent than with in-network services. So it will still cost you less to get your services within the POS network.

This is what is meant by two levels of insurance coverage, which are called "in plan" and "out of plan" health insurance. In plan coverage is usually more advantageous but it also has tighter restrictions imposed on the user. Like in case of HMO plans, in order to get full coverage at the "in plan" level you will have to provide a referral from your PCP and get your services within the network. You will also sometimes be required to get additional approval from your insurance administrator beforehand.

This all means that even sticking to the specialists and facilities of your POS network won't give you full coverage unless you provide a referral from your PCP. This is the so called "red tape", which is one of the biggest complaints about managed insurance plans and the formalities within them. However, when compared to indemnity plans, managed health care provides substantial money saving possibilities that can't be beaten.

The indemnity part of POS

POS plans provide the best of both worlds, that's why they are so popular. And when it comes to the indemnity part of POS plans, people find a lot of flexibility and freedom that just can't be obtained through typical managed care options. Just like in the case of PPO plans, you are still able to get insurance coverage even when addressing to a specialist outside of the POS provider network.

In other words, you can use "self-referrals" in order to get care from a specialist you choose. When treatment is required, you are free to choose any physician or facility without needing a special referral from your PCP, Still, you won't get much coverage when choosing this option, so flexibility still has its price.

However, this is a great way to avoid the restrictions typical for managed care plans. That will be very useful for those who have a long-term trusted physician outside the network. Still, in such a case you will have high co-insurance payments (up to 40%) that will make your visits a bit more costly if compared to a doctor from the POS network.

Finding the right plan

In order to get cheap health insurance with your POS plan you have to shop around first. Try getting as much health insurance quotes from different providers as you can, compare them and choose the right policy.