WHAT'S THE DIFFERENCE BETWEEN A HMO, PPO & PSO?
Do you know what those plan names really mean? At Don Cousins & Associates, we are here to help you understand these terms to that you can make the best decisions for your health insurance choices.
HMO (Health Maintenance Organization)
With this health plan, you choose a primary care doctor from your plan's network. He or she directs your medical care. And gives you referrals when you need to see a specialist, like dermatologist. With an HMO, you must go for medical care within your plan's network - or you won't be covered (except for emergencies). You normally pay a copay at the time of service. This is a fixed dollar amount, like $25.
Why you might like a HMO: You work with a doctor who knows your health best. And you can predict your costs.
PPO (Preferred Provider Organization)
With this health plan, you can visit any doctor - in the network or out. There are no referrals. And you don't have to pick a primary doctor - though you may want to. When it comes to costs, a PPO is unlike an HMO. You don't pay a fixed amount. You pay a percent of the bill, called coinsurance. For example, you pay 20% and your health plan pays 80%. If you go out of network for care, you will likely pay more.
Why you might like a PPO: You want the flexibility to visit any doctor you choose. Without any referrals, ever.
HRA (Health Reimbursement Arrangement)
This is a fund that works with a health plan, like an HMO or PPO. Your employer sets up and pays into the fund. Then, you can use it to pay for deductibles, copays and many other health care costs you'd normally pay out of pocket. The fund rolls over from year to year, as long as you remain in the plan. But if you change plans or leave your company, you can't take the fund with you.
Why you might like an HRA: You can use employer funds to pay less out of pocket. And most or all your of your preventive care is covered.
So, before you sign up for a health plan this year, call us at (504) 889-1898 for a free consultation. We will help you review all your options and choose the best health insurance policy for you, your family or your business.