A health insurance provider network is a list of doctors, health care providers, and hospitals that are contracted to a specific health insurance plan (PPO, POS, HMO or EPO). In these plans, the insurance company creates an entire list of doctors and facilities from which you have to choose. When you go to the doctor, you want to stay within your provider network to keep medical costs down. Health plans work to ensure that consumers have access to high-quality, effective care. Consumers benefit from peace of mind when receiving in-network care because it assures the provider meets quality care standards and has lower cost sharing and
Ten Things to Know About Health Insurance Deductibles
A health insurance deductible is the amount you pay out of pocket for your medical expenses before the insurance company starts applying your benefits and paying for your medical claims. Your deductible has to be met yearly. Plans with a higher deductible tend to have a lower monthly premium whereas plans with a lower deductible have a higher monthly premium. The cost of medical treatment out of pocket prior to meeting your deductible is still less than the actual cost of treatment without insurance coverage. (Bottom line: it’s less expensive to have health insurance than to go without). Insurance plans will still offer some benefits
HMO vs. PPO: What’s the difference?
Insurance can be complicated and difficult to understand. One of the biggest questions insurance agents get is, “What’s the difference between an HMO plan and a PPO plan?” Next people ask which route is better. All manager care plans have contracts with doctors, x-ray technicians, pharmacies, and other medical vendors. These contractors are part of your network. Some plans require you to seek medical attention within your network while other plans let you have more freedom in seeking medical care outside of your preferred network. HMO Plans: HMO stands for health maintenance organization. If you sign up for an HMO plan, you typically receive medical
Provider Networks: What are they & why are they important?
What is a provider network? And why is it important to you? Provider networks are groups of doctors and medical facilities contracted to perform medical services at a discounted rate for the members of health insurance plans. The participating doctors and medical facilities in a provider network are referred to as “in-network.” Conversely, doctors and medical facilities not participating in the provider network are considered “out-of-network.” Participating doctors and facilities vary from network to network, as well as carrier to carrier. The benefit of provider networks is that if you choose to see an in-network provider you can take advantage of the providers discounted rate
HMO vs. PPO: What’s the difference?
It is important to learn about your health insurance options, so that you will know which option is right for you, your family and/or your small business. What is an HMO? HMO stands for health maintenance organization. Health maintenance organizations (HMOs) contract with healthcare professionals and facilities, which make up a “provider network.” With HMO insurance you typically pay a small copayment to visit a doctor or a hospital within your HMO network. The benefit of HMO insurance is that it generally has lower premiums and copayments. A disadvantage of HMOs is that they are the least flexible type of health insurance. This is because