Health Insurance can be both overwhelming and extremely confusing. Even if you have had health insurance for years, you may not know exactly how it works and what different health plans are available.
The most prevalent is the Health Maintenance Organization more commonly referred to as HMO. HMO’s usually provide a list of physicians that a member can see and have rules and regulations that a patient must follow. The biggest complaint with HMO’s is the limited services that are offered.
HMO’s tend oversee the patients health very closely. Typically a patient must first see a primary care physician before they are able to see a specialist. The Primary Care Physician must refer the patient to specialist before the HMO will cover the cost of the specialist. Most plans allow for woman to pick an OB/GYN as well as a primary care. Some patients feel that the referral method is a hassle however it is how HMO’s try to keep their premiums and deductibles relatively low. Emergency situations do not require a referral.
There also HMO plans available with “open access” that do not require a Primary Care Physicians referral however they tend to have a higher co-pay and deductible.
