No one plans to get ill, but you can plan for medical care. Enrolling in a health insurance policy offers you guarantees that you will afford the best care available in case of any eventuality. However, shopping around for a health insurance cover is not easy. There are multiple types of health insurance and service providers to consider. Here are some benefits of health insurance and policy cover plans.
Why Do You Need Health Insurance?
Health insurance services provide the client with a variety of medical and financial benefits. For starters, health insurance makes medical care affordable, especially for chronic conditions and long-term illnesses. For instance, health insurance may help cover medical consultations, surgeries, organ transplants, and expensive drugs for cancer patients.
Significantly, insurance coverage offers discounted services in cases where clients have to pay from their pockets. Also, health insurance caters to routine medical check-ups and child wellness consultations. Thus, the client still gets benefits without necessarily having a severe condition. In a way, the paid-for routine check-ups contribute to healthy living. Finally, clients under health insurance coverage enjoy a high quality of medical care since participating hospitals operate with quality ratings.
Health Insurance Service Plans
Health Maintenance Organization (HMO) Cover
The HMO is a widely used health insurance coverage due to its features. In the HMO cover, a local network of health facilities and practitioners agrees to offer their services. The client has to choose a primary care provider (PCP). Basically, the PCP acts as the home base for your medical care but can refer you for specialist care within the network. Ordinarily, HMO caters for your preventive care costs, but you co-pay for non-preventive care.
Preferred Provider Organization (PPO) Plan
In the PPO arrangement, the client does not select a PCP. This flexibility means that the patient is free to consult any health care provider in the insurance network. Also, the PPO gives you full coverage for preventive care, and you co-pay for non-preventive care you receive within the network.
Exclusive Provider Organization (EPO) Cover
An EPO cover limits you to medical care within the participating healthcare providers' network. However, an EPO does not limit you to a primary care doctor or facility. Thus, clients under EPO can access any health care provider and specialist in the program.
Point of Service (POS) Plan
The POS combines the HMO and PPOs model. A client under the POS plan has a primary care provider who does routine consultations and specialist referrals. Then, the plan has co-payments and deductibles for non-preventive care. However, POS allows you to seek care from service providers outside the network under a co-payment arrangement. Thus, POS is ideal for people willing to pay more to consult specialists beyond the network.
The possibility of medical bankruptcy is not farfetched, given that healthcare can be expensive. Heath insurance services help you to manage the cost of treatment. Remember to assess the benefits and limitations of each health insurance service plan during selection.
Share