Health Insurance Plan 101: How to Choose the Ideal HMO Company for You

Opting for a health insurance plan that’s the right fit for you may be quite a challenge especially with today’s glut of HMO companies. But how do you really know which one to choose? Let this be your guide to get the most out of your health plan.

Assess Your Medical Needs

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There are different strokes for different folks especially when it comes to health care. You may be dazzled with an in demand, low-cost package but it may not suit your medical needs. To be sure of what kind of health plan to avail, here are some of the usual coverages of HMOs:

Benefits extension to family members
Prescription medicines reimbursement
In-Patient care (room and board accommodation, use of OR, ICU, Recovery Room, professional fees, and nursing services among many others)
Out-Patient care (treatment of minor injuries, X-ray, lab tests, routine, diagnostic and therapeutic procedures)
Preventive care
Emergency care
Accidental deaths
Maternity & dental benefits

HMOs tailor their health plans according to your need—whether you’re getting it for yourself or your loved ones.

Thoroughly Look into Your Options

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And by thoroughly looking into your options, we mean researching on the company and their service quality. If you are an employee and you’ve been designated a health insurance plan by your company that’s not ideal, you have the option to leave you employer-sponsored group plan, unless your company pays 100 percent of the premiums or if you agreed to take the plan as part of an employment or union agreement.

When browsing your options, always look for an updated summary of benefits. You can find the breakdown, the provider directory (affiliated doctors, clinics, and hospitals) on their website. Compare & contrast. And most of all, choose an established company, after all, this your health we’re talking about.

HMO vs. PPO vs. EPO

You’ve probably heard the terms HMO, PPO and EPO but you also probably don’t know their specifications.

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HMO

HMO stands for Health Maintenance Organization. HMO companies offer a wide range of health care services through a network of providers that contract exclusively with the HMO, or who agrees to provide services to members.

PPO

Preferred provider organizations offer more flexibility. PPO plans give you flexibility. You don’t need a primary care physician. You can go to any health care professional you want without a referral—inside or outside of your network.

EPO

Exclusive Provider Organizations may be a lot like HMOs but they generally don’t cover care outside the plan’s provider network. Members, however, may not need a referral to see a specialist.

Settle on a budget

Health care costs seem to increase and availing a health insurance plan can help you get the best medical care without burning a hole in your pocket. The secret to getting everything according to your budget is to ask for a quotation from as many health companies that you can, to make sure that you’re getting the best possible plan out there.

As detailed by The Balance, health insurance is not a luxury; it is a necessity. Purchasing health plans from trusted HMO companies is an investment you ought to do yourself the favor of having.