Medical Plans: Choosing The Right One For Your Family.

With the costs of medical treatment being what they are in the United States, many people value their health insurance plan as the most important benefit offered through their employer.

And for good reason too. Medical plans are vital for both the physical and financial well-being of most families. So choosing the right medical plans to meet either an individual’s, or a family’s specific needs is crucial.

It will be the focus of this article to explain the three primary types of medical plans offered today: Major Medical, HMOs, and PPOs.

Almost every employer incorporates one of these three types of health insurance models.

Major Medical:

The most flexible of the primary health insurance plans is major medical health insurance.

Under this format, the insured chooses a yearly deductible which must be met before the insurance company is required to pay any benefits.

After the pre-determined deductible has been met, the insurance company will then begin to pay benefits at an 80/20 percent ratio.

The primary benefit of major medical plans is the insured can choose any doctor or provider they want and be billed directly for services.

The downside is major medical insurance plans are typically the most expensive to carry.

The HMO:

The second most expensive of the primary medical plans is the HMO (or Health Maintenance Organization).

In an HMO, the insured signs up (as part of a larger collective) with a group of selected health care providers and is only allowed to choose other providers (such as specialists) who are also in-network.

Typically, in HMO medical plans, each person (or family) chooses a primary health physician who oversees (maintains) the overall health of the insured.

HMOs are popular due to their lower cost than standard major medical health insurance plans.

The PPO:

The final of the three primary medical plans is the PPO (or Preferred Provider Organization).

What separates the PPO from the HMO is the insured not only has the option to choose an in-network provider (and thus pay lower co-payments and deductibles), they also have the choice of choosing out-of-network providers.

The caveat is when an out-of-network provider is chosen, the insured is responsible for the often higher co-pays and deductibles.

Many people choose PPO medical plans over HMOs due to their flexibility to choose doctors and specialists both in and out of network.

Conclusion:

As you can see, the three types of primary medical plans available to most Americans today cover the full gamut of provider choice, price range, and flexibility.

The largest majority of American households cannot afford not to have medical insurance; so choosing the correct one for you and your family’s budget is paramount.