Shopping for group health insurance plan for your business? Choosing between HMO, PPO and POS health care delivery plan that suit your needs is the most important decision.
Learn the basic difference between the three health plans: The HMO is Health Maintenance Organization. HMO provides medical care to their HMO member. Under HMO plans a member is required to choose one primary care physician and is limited to use in-network hospitals and doctors except In case of emergency or can get referral from primary care physician. The member is required to make co-payments.
PPO is Preferred Provider Organization has network of physicians and the member is free to consult any of the physician and medical facilities those are in network. PPO policies have less coverage. Annual deductibles are applied before insurance starts and coinsurance is applied to the member.
POS is Point of Service plan which is the combination of HMO and PPO insurance plan where the member can consult any doctor or medical facility of his choice and there are no restrictions. Coinsurance and annual deductible also applied in POS.
Compare the features and benefits of the different plans: Features and benefits offered to employees by HMO plans are least expensive, lowest out of pocket cost, no deductible, no coinsurance and restrictions on using in-network providers. PPO plans offer greater choice of physician and greater access to specialist.
PPO member can also assist the specialist who is not in the company’s network but this will reduce the coverage and increase the cost to the pocket of employee. The PPO also charge deductible and coinsurance. POS plans offer greatest freedom to choose specialist, highest monthly premiums, deductibles and coinsurance. In case of POS it is difficult to estimate the out of pocket medical expenses.
Determine which plan meets your employee’s needs and your business situations: Older employees prefer excellent drug covering health plans whereas higher deductible plans are preferred by younger generation. Estimate the needs employees for mental health services, prescription drugs and well child care. Consider the cost sharing options those are offered by each plan. High deductible PPO lowers the monthly premiums and increases out-of-pocket expenses.
Determine which plan offers the best combination of health coverage for employees at the rates that fit to the company’s budget: HMO, PPO and POS group health insurance plans provides various benefits and coverage options which should be considered while you select any of the plan for your employees.
