Understanding HMO, PPO, and POS Health Insurance Plans

Understanding all the terms and conditions that can affect the cost of affordable California health insurance is very important when choosing a health care insurance plan. If you are looking for individual helath insurance but are not sure which type of health care plan to choose, here are the definitions of an HMO, PPO, and POS health insurance plans.

HMO Health Insurance Plan

A Health Maintenance Organization or HMO, is considered a cheap health insurance plan, but its also offers the least amount of flexibility to the individual or small business. The monthly premium for an HMO is usually lower than those of PPOs or POSs and has a cheaper copayment of around $5 to $15. Services such as visits to the doctor, medical treatment, preventative medicine and medical prescriptions are all available through the use of an HMO health insurance plan, but in exchange for the affordability you must see doctors and health care providers within the particular HMO’s network. If you are looking for a group health insurance plan, HMOs can be flexible in terms of the cost or percentage you are willing to pay of the cost of medical prescriptions.

PPO Health Insurance Plan

A Preferred Provider Organization or PPO, has a higher premium, or amount that you will be paying towards the health insurance plan monthly, but is much more flexible than a HMO. In a PPO health insurance plan in Califonria you are able to visit medical service providers that are “out-of-network” without the approval of the medical insurance provider. If you choose to stay within your network of health care providers, the benefit will be seen in a lower co-pay for all of your visits, prescriptions, etc. If you are planning on using health care providers outside of the PPO network researching which Califonria health insurance companies have the best, most efficient reimbursement plans is highly recommended.

POS Health Insurance Plan

A Point-of-Service Plan, or a POS, combines a HMO and a PPO plan with a moderate cost for the services, premium and copayments. A POS requires that you have a primary service provider within your network, but you are able to visit specialists and out-of-network providers, if primary care physician makes a referral. If the referral is received and approved by your POS health insurance provider, they will most likely reimburse you for these out of pocket expenses. Researching the best POS plans with the most success with claims and reimbursement plans is necessary to find the best health insurance plan for your money.