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PPO – What Your Didn’t Know

There are two major types of health insurance that consumers can choose from, a PPO plan or an HMO plan and you’ll run into both of these when you get your health insurance quotes. Today we are going to talk about the PPO plan.

PPO stands for Preferred Provider Organization. A PPO plan is an insurance policy that allows you to seek medical treatment from a designated provider who is a part of a network of providers and medical treatment facilities that was created by the insurer. Everyone within the network agrees to work for a certain price. If you have a coinsurance amount in the plan, then this agreement to work for a certain price can help you keep your out-of-pocket costs affordable.

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Indemnity Plans

When you look for health insurance quotes online, you often hear about HMO and PPO plans, but there is another type of health insurance policy organization out there, and it is called an indemnity plan. With an indemnity plan, there is no need for you to visit a certain network of doctors. Since this is a strict requirement of HMO plans and an activity that affords major discounts in a PPO plan, the ability to have absolutely no network of doctors in an indemnity plan is a great benefit.

The Benefits of Indemnity Plans

In addition to being given the freedom to visit any physician or specialist you want under an indemnity plan, you will also not generally be required to choose a primary care physician. This means you also won’t be forced to get referrals before you visit a specialist.

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HMO – The Full Story of Health Insurance

When you are searching for low cost health insurance an HMO plan is likely to come across your radar. HMOs, or health maintenance organization plans, offer some of the lowest cost full coverage insurance benefits but they have certain drawbacks.

With an HMO, you will be treated exclusively by doctors and medical treatment centers that are in the HMO network. If you receive treatment from someone outside of this network, unless it is an unpreventable emergency, your claim is likely to be denied. Unlike a PPO, HMOs do not offer any coverage for treatment received outside the network unless it is emergency treatment in an area with no network treatment centers or physicians. So if you have a favorite doctor that you or your children visit, make sure he or she is on the network list before you take out the HMO’s cheap health insurance coverage. If you don’t, then you will be forced to pay out-of-pocket for the full cost of all your visits to this physician.

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Health Insurance Terminology

You cannot be sure that you’ve gotten the best health insurance coverage unless you understand health insurance terminology. Here are some of the most commonly used terms in the health insurance industry.

COBRA: The Act that allows for continuation of group coverage for a limited time after you leave the group.

Co-insurance: The amount you must pay for treatment after copayments and deductibles.

Copayment: The fixed amount that you must pay out-of-pocket for physician visits, medical procedures and prescription medications.

Deductible: The out-of-pocket amount you must pay before your policy benefits start kicking in.

Exclusions: Any medical conditions or illnesses whose expenses are not covered by your insurance policy.

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COBRA Coverage Explained

COBRA is the acronym for a health insurance portability act signed into law during the 1990′s. Thanks to COBRA, if you leave an employer who is providing your group health insurance coverage, you can keep the coverage for 18-36 months even though you no longer really qualify for the group coverage since you are not a member of the group. COBRA is a great benefit to many people-but not every employee who leaves an employer with group benefits should take advantage of COBRA coverage.

COBRA coverage is extremely expensive. If you are someone in relatively good health, who rarely goes to the doctor and has no pre-existing conditions, then COBRA coverage might not be the best use of your financial resources. Instead, you could search for low cost health insurance on an individual basis and get your own policy, not hinged on group participation, that can cover you for a fraction of the cost of a COBRA policy.

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