Moeller Life & Health Insurance

Types of Health Coverage Explained

Health Insurance presents many types of coverage with choices of benefits to best meet any particular interest and budget.  The most popular plans are PPO & HMO.

A PPO (Preferred Provider Organization) Health Insurance Plan offers the ability to use the healthcare provider network with no restrictions. You can see any doctor without a referral. Some have nationwide directories. A PPO Health Insurance Plan will usually have a deductible choice and co-insurance out of pocket amount. Co-insurance is implemented after a deductible is met. The insurer then begins to pay a percentage of the covered expenses. It can be at 80% where the insured pays 20%. Or it can be 70/30, 60/40, and 50/50. The out of pocket amount is your portion of co-insurance until it reaches the dollar amount according to your Health Insurance Plan benefits.

An HMO (Health Maintenance Organization) Health Insurance Plan is very convenient. They usually don’t have deductibles, rather simple co-pays for covered services. The network of providers is within state lines. Currently most HMO’S have direct access to the network providers not requiring a referral to access a network specialist.

An HMO/POS (Point of Service) Health Insurance Plan features out of network benefits with an HMO Health Insurance Plan. An HMO/POS Health Insurance Plan allows the utilization of doctors and hospitals outside of the network under a different benefit structure usually with deductibles and co-insurance amount.

A Catastrophic Health Insurance Plan limits coverage to surgery and hospital stays protecting the insured from great expenses.

If you would like to learn more about these plans and others that we offer such as Cancer Plans, Indemnity Plans, etc., please contact us and our Health Insurance expert and consultant will be happy to assist you in finding the best possible protection at the lowest possible cost.