Managing health care – HMO, PPO and POS

There are different health care policies offering various options for coverage – HMO, PPO and POS.

HMO policies charge nominal premiums for health insurance but they offer very less flexibility in choosing a provider. In addition, they do not reimburse in case the insured chooses outside the network. Even the specialists you consult should be a part of the network.

PPO policies are more flexible in choosing a provider. These policies offer partial reimbursement while taking consultations outside the network and charge high co-insurance and co-payment amounts. In case the insured needs to consult a specialist, he does not require a referral

POS function at an intermediate level between HMO and PPO. In the case of POS policies, the insured is entitled to get full reimbursement in case of undergoing treatment out of network provided your PCP (Primary Care Physician) gives you a referral.

Indemnity Plans do not have any network associated with the health insurance coverage and reimburses about 80% of the treatments costs incurred by the insured. These plans gives the maximum flexibility to the insured to choose their own health care provider