There are several health insurance plans available in the US: Managed Care, Fee-for-Service Plans, Health Maintenance Organizations (HMOs), Point-of-Service Plans (POS), Preferred Provider Organizations (PPOs).
Managed Care Plans.
Managed care is very popular in the United States. This type of plan helps insurance companies to control the medical care costs. All kind of plans have some sort of managed care program. Generally speaking you might be asked to take approval from your insurance company before any medical care is received otherwise the costs may not be covered by them.
Fee-for-Service Plans.
Fee-for-Service Plans is the traditional health insurance type of plan in the US. Under this plan the insurance company will pay your fees when you use medical care.
This is a flexible medical insurance plan as it allows switch of doctors and hospitals and you can do this through the country. However you have to careful as only part of the expenses are covered by the insurer and you have to carefully check the conditions of your insurance policy not to end up with huge medical care costs that you have to pay.
Health Maintenance Organizations.
Health Maintenance Organizations (HMOs) are prepaid plans. If you are a member you pay some fee every month. In return when you need to use any kind of medical care it is arranged from the organization. The HMOs use their group of doctors and practices or other doctors that have contact with the group. Usually your family members are also covered by this kind of health insurance plan.
If you are insured under this plan you will have to choose a primary doctor who will monitor your health and refer you to specialist when needed.
Point-of-Service Plans.
The Point-of-Service Plans (POS) will provide you with medical services if you pay a monthly fee. They will either refer you to a doctor from the doctors working in their organizations or to other medical care providers in the plan. Even if you choose to use medical case services outside the plan your heal care expenses might be covered by the policy.
Preferred Provider Organizations
The Preferred Provider Organizations (PPOs) is some kind of combination between the fee-for-service plan and a health maintenance organization. If you are insured under this plan you will have to choose a doctor or a hospital from the list of approved health care providers. Similar to the HMOs you can choose to be treated by a medical institution or a doctor outside their network and still get some coverage. However you might need to pay the larger proportion of the bill yourself.
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Mr. Berr,
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Wayne
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