Understanding the difference between HMO, PPO, and POS

Health Support Organizations (HSOs), Preferred Provider Organizations (PPOs), and Point-of-Service Plans (POS) are the examples of set health concern organizations. The main idea of creating a managed care institution is to grant its clients with access to a comprehensive way of clinical care that guarantees quality service and reasonable prices.

Health Support Organizations

If the coverage you have chosen is provided by a Health Support Organization, you have to select an HMO physician to be your first medical consultant. The doctor will coordinate your referrals to specialists, such as a dermatologist, cardiologist or surgeon as well as everything else.

Because of the conditions in a choice of HSO network services, it's of vital importance to check the physician listing and hospital affiliations for the HSO you are taking into consideration. Averagely, HSOs are the cheapest health institutions for everybody from a boss to the secretary. Everything from a doctor’s receipt to the way he is planning to treat you is covered by the premium of every month.

Co-payment exists in cases of visits that vary based on the type of service provided as well as the service you might select. But there is no such thing as co-insurance. There is such a possibility as your own choice in plan configuration as it gives an opportunity to their clients to visit any provider they want outside of the network. Such opportunity provides the members with an access to an HSO network and a PPO network, though the PPO usually includes deductibles and co-insurance.

Preferred Provider Organizations (PPO)

A Preferred Provider Organization is known to be more flexible than a traditional HMO insurance plan, but it works with a list of physicians and hospitals that is said to be "within the PPO network." Going for a PPO plan, you will have to visit an out-of-network provider and get some coverage for the services they provide. Yet, you will usually need to give money for co-insurance or the difference between the network and the non-network prices. If you suddenly decide you don’t want to commit yourself to the PPO network, you may have to invest money for the treatment and attach the receipt to your PPO insurance specialist for a shared reimbursement.

HMO vs. PPO Prescription Plans

The two plans may have a benefit towards the prescription of the medicine included, if you, as an employer, offer it. The coverage price may vary. Most plans will include a higher co-payment if the generic formula if chosen over a brand name drug (if it was recommended by the physician, of course).

Point-of-Service Plan (POS)

The POS plan is more of a mixture of the HSO and PPO plans. You are asked to designate an in-network physician that will further on be your primary health care provider. Out-of-network doctors are welcome if you choose, but once again in doing so, you are obliged to have to pay most of the cost yourself, unless a primary care physician advices that specific doctor to you.

There is a big variety for today’s small businesses and some health insurance companies are willing to provide you with more than one cheap health insurance option to your employees.