Managed care plans are relatively new when you consider that the first group health insurance indemnity plans reach back to the 1930’s. The concept of managed health care plans were developed with an eye towards lowering the cost of health insurance because indemnity plans were largely viewed as escalating too quickly in price form year-to-year.

HMO plans are generally the least expensive of health insurance programs managed or otherwise. HMO’s are also generally speaking the most restrictive of all health insurance plans. HMO plans are perceived as requiring the least amount of paperwork and having very low premiums when compared with other health insurance plans. There is an emphasis in most HMO’s on preventative care and improvement of health overall. Think of things such as weight loss programs, smoking cessation, exercise and nutrition for specific health issues and you have a picture of the preventative and maintenance issues frequently addressed by this type of health insurance plan. HMO plans tend to want you to be pro active in your health insurance versus reactive. Generally speaking physicians must be in the plan, or at the very least a covered person must be referred to any specialist not a part of the health insurance plans current physician roster. The referral must be on file and in writing for the health insurance plan of this type to pay benefits. The belief in this type of health insurance program is in part “An ounce of Preventions is worth a Pound of Cure”.

Preferred Provider Organizations, PPO’s give financial incentives (if you will) to their members to stay within the physician network. A covered person may see any specialist within the participating network of physicians without first getting a referral. Additionally routine co-payments (your share of the bill) for this type of health insurance are normally around $10-$20 for visits where treatment takes place during normal routine hours. There may be higher co-payments for weekend or after hour’s facilities even if they are a part of the health insurance plan. Additionally co-payments for use of a hospital emergency room are generally higher in a Preferred Provider health insurance program. It is not always necessary to choose a primary physician as a participant in this type of health insurance plan. To check the affordability of your health insurance plan click here for a free quote.

Point of Service plans for health insurance provide a greater degree of flexibility than HMO plans but are similar in that you are required to select a primary care physician. It is possible to see a physician outside the network. When your receive care from a source outside of the network, the health insurance benefits are normally paid at a substantially reduced level than had a network physician been utilized for treatment. Like HMO plans the POS health insurance programs tend to offer preventative care and services. You must choose a primary care physician from within the network. Additionally you must receive a referral from your primary care physician prior to treatment from a non-network physician if this is the type of health insurance plan you choose.

Medicare is the health insurance program that is the primary source of health care for senior citizens in the United States. Medicare is a joint venture between the various states and the federal government. Not every physician is a Medicare participating provider. Medicare has two basic components. Part A is the component that provides for in hospital stays. Part B is the component that provides for outpatient services. There are no provisions in Medicare for second opinions as seen in most of the other health insurance plans. It is possible and indeed recommended that participants in Medicare purchase a supplemental plan to bridge the gaps in health insurance coverage. Medicare was conceived of to offer affordable health insurance to the nations economically challenged elderly. The supplements to this particular form of health insurance will not be discussed in this part of the site due to the nature and scope of the plans. Suffice it to say that there is a wide variety of Medicare supplemental health insurance plans to choose from. Any plan offered under the specific type approved must provide all of the benefits mandated by the government. This allows the participants in Medicare to choose those benefits they believe are most beneficial to them in a health insurance policy. The plans are lettered A through J by every carrier. Since the benefits are mandated the only thing that changes from one health insurance company to another is the premium and the state(s) in which coverage is offered. Health insurance companies are not required to offer each and every plan in every state.