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Different Types of Health Insurance Plans

There are three main types of health insurance plans available in the U.S. Under an indemnity plan, you pay a premium for the insurance, and a fixed percentage of covered expenses, plus any deductible and co-payment. You may choose your physician, and refer yourself to specialists. A PPO (Preferred Provider Organization) is similar to an indemnity plan. However, you pay less for care received through one of the plan's preferred physicians or facilities. Under an HMO (Health Maintenance Organization), you pay a premium for the insurance and a fixed co-payment for covered services. You must select a "primary care physician" approved by the HMO. All treatment, including that rendered by specialists and at facilities outside the HMO network, must be done on the basis of a referral by your primary care physician and must sometimes be pre-approved by the HMO. The HMO may refuse to pay for services that were not recommended by your primary care physician.

HMO FAQ
Sites which offer glossary of terms, legislative updates and data relevant to HMOs. There are also other linking sites which will provide the viewer with polls, articles and personal accounts of experiences with HMOs including information from government resources (Senate debates) and health care professional associations (American Medical Association). These web sites focus on the types of covered medical services, choices of primary care physicians, and costs associated with HMOs such as deductibles, copay and premiums. The reader will even find tips on choosing a primary care physician, which is almost always a requirement of an HMO.

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Managed Care
Managed care is a general term for many different types of health insurance coverage. It has many names and labels such as health maintenance organizations (HMO), preferred provider organizations (PPO), and point-of-service (POS) plans. If you choose to participate in an HMO, you are required to obtain care from a specific list of physicians, hospitals, or other healthcare providers. There is more of choice offered in a PPO. It is similar to an HMO except that you can choose to seek care from a provider who is not part of the plan. However, if you do so, you will have to pay more from your own pocket than if you went to a provider who was a part of the PPO.

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