HMO, PPO, PSO, Cost Sharing, Medicare
Not Having Health insurance Is Not An Option
An unexpected medical bill can destroy your future even if you survive the event.
HMO's
An HMO plan, (Health Maintenance Organization) is a health plan where you typically receive care from a specific network of doctors and hospitals, requiring you to choose a primary care physician (PCP) who manages your care and usually needs to provide referrals for specialist visits; generally offering lower premiums in exchange for managed provider choice within the network.
PPO
A PPO plan (Preferred Provider Organization) is a health insurance plan where you pay less if you use providers within the plan's network of preferred doctors and hospitals, but you still have the option to see out-of-network providers at a higher cost; essentially giving you more flexibility to choose your doctors while incentivizing you to stay within the network for lower costs.
POS
Point of service (POS) health insurance is a health plan that allows you to choose between in-network and out-of-network providers. You pay less for care within the network, but you may pay more if you use an out-of-network provider.
How it works
- You choose a primary care provider (PCP) from the POS network.
- You can see a specialist without a referral, but your PCP should be aware of the providers in the network.
- You can use out-of-network providers, but you'll pay more for your care.
- Emergency services are covered at the highest benefit level, regardless of whether the provider is in-network.
Cost Sharing
An alternative to traditional health insurance (health care sharing plans) But unlike insurance, these plans are unregulated and don’t have to meet minimum health benefits mandated by the Affordable Care Act.
Navigating health insurance plans can be complicated, consuming and frustrating. Yet hundreds of thousands of Americans have enrolled in an alternative to traditional Insurance.
Members of these plans often share similar religious beliefs agree to make monthly payments to help pay for other members medical expenses. Unlike insurance, these plans are unregulated and they don't have to cover pre-existing conditions or meet the other minimum health benefits mandated by the Affordable Care Act.
These plans appeals to people who look for a low cost alternative to health care, insurance. across the nation, and found 1.7 million people had enrolled in these plans. And that was more than even industry individuals had had realized.
Medicare
Part A:
Helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care.
Part B:
Helps cover:
- Services from doctors and other health care providers
- Outpatient care
- Home health care
- Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment)
- Many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits)
Part C:
is a Medicare-approved plan from a private company offering an alternative to Medicare for your health and drug coverage. These “bundled” plans include Part A, Part B, and usually Part D (prescriptions)
- Usually you can only use doctors in the plan’s network.
- Plans may have different out-of-pocket costs than Medicare or supplemental coverage like Medigap. You may also have an additional premium.
- Plans may offer some extra benefits that Original Medicare doesn’t.