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Whether health insurance is for you, your family or your business, selecting the right plan is important. Understanding the various plans, costs, benefits and access to services are the key parts to consider when making your choice.
Health Maintenance Organization (HMO): Generally lower in cost, an HMO offers coverage for doctor’s office visits, preventative care and hospitalization at a fixed monthly cost with a co-payment per office visit. You choose your primary care physician from within the plan. Any treatments requiring a specialist come from a referral by your chosen plan physician.
Preferred Provider Organization (PPO): Offers more choices in selecting physicians within the PPO network. You are not required to obtain a referral to see a specialist. The monthly cost is higher than an HMO and you pay a percentage of each medical visit (co-pay) and meet a deductible before benefits are paid. If you use a physician outside the plan network, your expenses will be more.
Point of Service (POS): A blend of HMO and PPO plans. As in an HMO, you select your physician from within the plan. You can also see a physician outside the plan network and still receive coverage at a higher payment. POS gives you the flexibility to seek treatment from both in in-network and out-of-network physicians.
Health Savings Accounts (HSA): An excellent choice for individuals and families who want to control their health insurance costs by combining a lower cost high deductible insurance plan with a tax advantaged savings account and network discounts. An HSA is a savings or investment account created for the purpose of paying for medical expenses. Recent Medicare legislation created HSA’s to encourage the use of high deductible insurance plans together with personal savings to create a more efficient method to fund the increasing cost of medical care while providing tax advantages to a qualifying savings account. The HSA is used to pay for eligible medical expenses not covered by insurance. The contributions to the HSA are deductible up to certain limits by reducing the adjusted gross income.
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