305-456-7783Health Insurance
Health insurance is a type of insurance coverage that covers the cost of an insured individual's medical and surgical expenses. Depending on the type of health insurance coverage, either the insured pays costs out-of-pocket and is then reimbursed, or the insurer makes payments directly to the provider.
See the most common types below.
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Preferred Provider Organization (PPO)
A PPO plan is a Preferred Provider Organization. With a PPO plan, you are encouraged to use a network of preferred doctors and hospitals. These providers are contracted to provide service to plan members at a negotiated or discounted rate. You generally are not required to designate a Primary Care physician but will have the choice to see any doctors or specialists within the plans network.
Health Maintenance Organization (HMO)
An HMO is a Health Maintenance Organization. With an HMO plan, you generally have a lower out-of-pocket expense but also have less flexibility in the choice of physicians or hospitals than other plans. An HMO may require you to choose a primary care physician (PCP). With a PCP, they will take care of most of your health care needs. Generally to see a specialist, you will need to obtain a referral from your PCP.
Exclusive Provider Organization (EPOs)
An EPO is an Exclusive Provider Organization. EPO plans are similar to HMO plans because they have a network of physicians their members are required to use except in the case of emergency. Members will have a Primary Care Physician (PCP) who will provide referrals to in-network specialists. EPO members are responsible for small co-payments and may require a deductible.
Point of Service (POS)
A POS is a Point of Service Plan. POS plans combine features of an HMO and a PPO plan. Just like an HMO, POS plans may require you to choose a Primary Care Physician (PCP) from the plan's network providers. Generally services rendered by the PCP are not subject to the plans deductible.