In general, individual health insurance is a form of contract between you and the insurer (insurance company) to pay all or most medical expenses, including hospitalization, medications, dental care, see a specialist, and some treatments (radiotherapy, chemotherapy, etc.). Whatever your needs, you will most likely choose one of these plans, fee-for-service, HMO (Health Maintenance Organizations), or (PPO) of the participating agency provider.
HMO (Health Maintenance Organizations) – The maintenance organizations (HMO) plans are managed care coverage health offered to members by hospitals, physicians and other health professionals who are in their network. This, with its service, limited to members of your network.
Advantages: Unlike pay service plans, you pay in advance, although some of them require participation fees. Is it not the forms necessary to submit the forms after the refund. In addition, HMOs usually charge a lower cost.
Disadvantages: You can use the providers of health care that are associated with the organization. (Most maintenance organizations health HMO) tend to refuse certain treatments. While some accept HMO members to consult your doctor or specialists who are not in your network, often require additional charges.
(PPO) of the participating agency provider - also known as Preferred Provider Organizations, is an organized form of managed care physicians, hospitals, clinics and other healthcare professionals who sign a contract with a company of insurance to provide health services to its members at discounted prices. Typically, PPOs cost more than traditional HMOs but offer more options to their members.
Advantages: Preferred Provider Organizations offer more flexibility to its members, have an extensive network of doctors and hospitals. You can take the service of health professionals who are not part of their network (they are often victims of certain charges). Low participation in payment for the care of primary care physicians. Also, do not need a referral to see a specialist.
Disadvantages: PPO cost more than traditional HMOs. You could do more co-payments (usually $ 10 to $ 30) when you visit a health professional.
