In order to make the best choice when it comes to your health insurance, you need to understand the different types of managed care insurance policies that are available. Most insurance coverage these days involves one of the three main types of managed care and you need to decide which one works for you. At Arial Insurance Group in Chicago, IL, we understand health insurance and we will share our knowledge to help our customers make the right choice.
The Different Types Of Managed Care: What You Need To Know
HMO
The HMO (Health Maintenance Organization) is the most common type of managed care, 34% of those with insurance have an HMO. One of the reasons, no doubt, is that it is the least expensive. But the trade-off is that it is also the most restrictive. With an HMO, you must have a primary care physician within the network and they manage your care. You will usually need to get a referral to see a specialist. You must see providers who are in the network in order to have coverage. In most cases, you are only allowed to go outside the network in case of an emergency.
PPO
With a PPO (Preferred Provider Organization), you still have a network of providers that are the most affordable to use. You are not required to have a primary care physician and you don’t need a referral to see a specialist. You have the option of going outside the network and you will be covered, but you will likely have to pay more than you would with an in-network provider.
POS
POS stands for Point of Service and it is a hybrid of an HMO and PPO. You must have a primary care physician and need a referral to see a specialist, but you can go outside the network.
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