There are two main coverage categories of health insurance, each having many different policy types.
The two main coverage categories are:
PPO plans allow you to choose any doctor or hospital that accepts PPO without a written referral from your primary care doctor. PPO plans allow the insured to choose a doctor or hospital from a list of “preferred” providers in order to receive maximum benefits. You will usually have to pay a co-pay with this policy type, meaning that every doctor, lab, hospital visit you pay a set amount. Also, it is your responsibility under these types of plans to make sure your doctor sends you to other “preferred” providers.
HMO plans allow you to choose any doctor or hospital on the plan list that except HMO and you MUST get a referral to go to any other doctor, specialist or hospital. HMO’s coverage is more limiting, but the cost is usually cheaper than PPOs. The drawback to an HMO is this policy type requires a “deductible.” This means you pay a set amount, for example $100.00, before the insurance company begins paying benefits. This amount can run from $100.00 to thousands, pending on your policy, health history, etc. After your deductible is paid you will pay only your co-payment. This ranges anywhere between zero and hundreds, again pending on your policy, health history, etc.
For example, most plans will pay 75% to 85% of all eligible medical costs above the deductible you pay the remainder.
Government Sponsored Health Programs
Medicare is a federal program, which provides medical coverage for people over the age of 65, and for those who are permanently disabled. Contact your local Social Security office for more information and enrollment instructions, click here.
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