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How to Choose the Right Coverage Plan

Today, having affordable health insurance is not a luxury that most can avoid. Ensuring that you can care for the well-being of yourself and your loved ones is a necessity.

However, comparing plans can seem daunting. How can you tell which offering is best for you and your family?

Will you be able to keep your same physicians, or will you need to switch to a new provider? Will you need to obtain a referral before you can visit a specialist? What is the difference between an HMO, a POS and a PPO?

There are many questions one must ask before choosing a product. Fortunately, there are some fundamental components that you can compare to assist in making this important decision.

Group versus Individual Health Insurance

There are two primary types of medical insurance that one can acquire. The first is group coverage, and is most often recognized as the option offered by one's employer. With a group plan, you often do not need to complete a lengthy questionnaire or undergo a medical exam in order to be approved. In addition, most group offerings do not deny coverage for preexisting conditions.

However, not everyone has access to this option through his or her employer, or the product offered by the employer might not be ideal for the individual. In such a case, you can obtain protection through an individual offering.

When applying for individual protection, you likely will need to complete a questionnaire and coverage for preexisting conditions could be denied. However, there are many companies out there, and in such a competitive market, one is sure to find an affordable offering that is just right.

HMOs, POSs and PPOs

When it comes to getting covered, there are three primary organizational structures: an HMO, a POS and a PPO.

An HMO, or health maintenance organization, is able to provide affordable comprehensive care at predetermined discounted rate by contracting with specific providers and by covering a large number of individuals.

In many cases, HMO members are able to visit only those physicians who are contracted with the HMO. In addition, HMOs often limit coverage of any treatments deemed as unnecessary. While these limitations might feel restrictive to an individual at times, these practices are what help the HMO keep their overall care costs down and rates low.

A POS, or point of service policy, also offers its customers discounted care costs by contracted with physicians. Members of a POS are able to see a physician outside of this network, but they will be able to take advantage of the plan's discounted fees by sticking with providers within the POS's network. Additionally, POS policyholders do need to obtain a referral from their POS primary care physician before seeing a specialist.

A PPO, or preferred provider organization, also contacts with a group of physicians in order to provide its policyholders with predetermined rates and discounts. Like a POS, PPO plans do allow consumers to visit doctors outside of the plan's network, but again, members can save money by staying within the specific network. A key difference between a PPO and an HMO or PPO is referrals - PPO customers are able to see specialists without obtaining a referral from their primary care specialist firs.

Compare as Many Options as Possible

To ensure that you find the best product for you and your family, you should obtain and compare as many policy quotes as you can. To assist you in your search, just complete our brief online form and you will automatically receive several affordable quotes that you can compare.

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