Call Us Today! (866) 639-1662
Alderette Insurance Agency, Inc.
Call Us Today! (866) 639-1662
Health Maintenance Organization (HMO)
HMO plans are network based plans which require members enrolled in the plan to seek routine and follow up care within a specific network (emergency care is always covered in-network regardless of where it occurs). Members in an HMO (in most cases) must choose a primary care physician (PCP). The PCP acts as a gate keeper within a chosen network and referrals from the PCP are required to see specialist doctors within the network for non-emergency care. If an HMO member seeks care outside of the HMO network for non-emergency care, then the member could be responsible for 100% of the cost. Health care costs tend to be lower and more predictable with HMO plans because of predetermined contracts with networks of health care providers. HMO plans have a strong emphasis on preventive care which helps to diagnose and treat conditions early thereby helping to save costs.
Preferred Provider Organization (PPO)
Just like HMO plans, PPO plans are also network based plans. However, what makes them different than HMO plans is that covered members have the option of seeking care outside the PPO network and still be covered. An important feature to understand about PPO’s is that the share of cost (i.e. deductibles, copays and coinsurance) the member is responsible for is significantly lower if care is received inside the PPO network then if the member receives care from outside the network. Premiums, deductibles, copays and coinsurance tend to be higher compared to HMO plans.
Point of Service plans (POS)
POS plans are a type of managed care plan that is a hybrid of HMO and PPO. If an enrolled member receives care outside the plan network without a referral, then the member will be responsible for 100% of charges. However, if the member is referred to an out of network specialist by their primary care physician then the plan will cover the services (in many cases at a higher out-of-network charge to the member).
Exclusive Provider Organization (EPO)
Like POS plans, EPO plans are also a type of managed care plan that is a hybrid of HMO and PPO. Members of an EPO do not have to choose a primary care doctor (unlike an HMO). Most of the time EPO members do not need to get referrals to see specialists who are in-network (similar to a PPO). However, like an HMO, EPO members can only use doctors and hospitals within the EPO's network for non-emergency care. EPO members will not be covered if they go outside the network for routine or follow up care (unlike a PPO). If a member receives care out-of-network, the EPO plan will not pay for any services (the only exception is an emergency or urgent care situation).
High Deductible Health Plan (HDHP)
High Deductible Health Plans are self explanatory. These types of plans are really designed for younger, single people without dependants who are healthy and do not need much medical care beyond preventive services. The attraction of these plans is simply that they have low premiums compared to traditional health insurance plans. However, those who are interested in a HDHP may want to pair it with a HSA.
To speak with a group insurance specialist, call us now at (866) 639-1662 or click here to get a free quote.
Health Maintenance Organization (HMO)
HMO plans are network based plans which require members enrolled in the plan to seek routine and follow up care within a specific network (emergency care is always covered in-network regardless of where it occurs). Members in an HMO (in most cases) must choose a primary care physician (PCP). The PCP acts as a gate keeper within a chosen network and referrals from the PCP are required to see specialist doctors within the network for non-emergency care. If an HMO member seeks care outside of the HMO network for non-emergency care, then the member could be responsible for 100% of the cost. Health care costs tend to be lower and more predictable with HMO plans because of predetermined contracts with networks of health care providers. HMO plans have a strong emphasis on preventive care which helps to diagnose and treat conditions early thereby helping to save costs.
Preferred Provider Organization (PPO)
Just like HMO plans, PPO plans are also network based plans. However, what makes them different than HMO plans is that covered members have the option of seeking care outside the PPO network and still be covered. An important feature to understand about PPO’s is that the share of cost (i.e. deductibles, copays and coinsurance) the member is responsible for is significantly lower if care is received inside the PPO network then if the member receives care from outside the network. Premiums, deductibles, copays and coinsurance tend to be higher compared to HMO plans.
Point of Service plans (POS)
POS plans are a type of managed care plan that is a hybrid of HMO and PPO. If an enrolled member receives care outside the plan network without a referral, then the member will be responsible for 100% of charges. However, if the member is referred to an out of network specialist by their primary care physician then the plan will cover the services (in many cases at a higher out-of-network charge to the member).
Exclusive Provider Organization (EPO)
Like POS plans, EPO plans are also a type of managed care plan that is a hybrid of HMO and PPO. Members of an EPO do not have to choose a primary care doctor (unlike an HMO). Most of the time EPO members do not need to get referrals to see specialists who are in-network (similar to a PPO). However, like an HMO, EPO members can only use doctors and hospitals within the EPO's network for non-emergency care. EPO members will not be covered if they go outside the network for routine or follow up care (unlike a PPO). If a member receives care out-of-network, the EPO plan will not pay for any services (the only exception is an emergency or urgent care situation).
High Deductible Health Plan (HDHP)
High Deductible Health Plans are self explanatory. These types of plans are really designed for younger, single people without dependants who are healthy and do not need much medical care beyond preventive services. The attraction of these plans is simply that they have low premiums compared to traditional health insurance plans. However, those who are interested in a HDHP may want to pair it with a HSA.
To speak with a group insurance specialist, call us now at (866) 639-1662 or tap here to get a free quote.
Health Maintenance Organization (HMO)
HMO plans are network based plans which require members enrolled in the plan to seek routine and follow up care within a specific network (emergency care is always covered in-network regardless of where it occurs). Members in an HMO (in most cases) must choose a primary care physician (PCP). The PCP acts as a gate keeper within a chosen network and referrals from the PCP are required to see specialist doctors within the network for non-emergency care. If an HMO member seeks care outside of the HMO network for non-emergency care, then the member could be responsible for 100% of the cost. Health care costs tend to be lower and more predictable with HMO plans because of predetermined contracts with networks of health care providers. HMO plans have a strong emphasis on preventive care which helps to diagnose and treat conditions early thereby helping to save costs.
Preferred Provider Organization (PPO)
Just like HMO plans, PPO plans are also network based plans. However, what makes them different than HMO plans is that covered members have the option of seeking care outside the PPO network and still be covered. An important feature to understand about PPO’s is that the share of cost (i.e. deductibles, copays and coinsurance) the member is responsible for is significantly lower if care is received inside the PPO network then if the member receives care from outside the network. Premiums, deductibles, copays and coinsurance tend to be higher compared to HMO plans.
Point of Service plans (POS)
POS plans are a type of managed care plan that is a hybrid of HMO and PPO. If an enrolled member receives care outside the plan network without a referral, then the member will be responsible for 100% of charges. However, if the member is referred to an out of network specialist by their primary care physician then the plan will cover the services (in many cases at a higher out-of-network charge to the member).
Exclusive Provider Organization (EPO)
Like POS plans, EPO plans are also a type of managed care plan that is a hybrid of HMO and PPO. Members of an EPO do not have to choose a primary care doctor (unlike an HMO). Most of the time EPO members do not need to get referrals to see specialists who are in-network (similar to a PPO). However, like an HMO, EPO members can only use doctors and hospitals within the EPO's network for non-emergency care. EPO members will not be covered if they go outside the network for routine or follow up care (unlike a PPO). If a member receives care out-of-network, the EPO plan will not pay for any services (the only exception is an emergency or urgent care situation).
High Deductible Health Plan (HDHP)
High Deductible Health Plans are self explanatory. These types of plans are really designed for younger, single people without dependants who are healthy and do not need much medical care beyond preventive services. The attraction of these plans is simply that they have low premiums compared to traditional health insurance plans. However, those who are interested in a HDHP may want to pair it with a HSA.
To speak with a group insurance specialist, call us now at (866) 639-1662 or tap here to get a free quote.
By using this site, you acknowledge that you have read and agree to the Terms of Service and Privacy Policy. Please read our privacy policy carefully to get a clear understanding of how we collect, use, protect or otherwise handle your Personally Identifiable Information in accordance with our website. Alderetteinsurance.com is privately owned and operated by Alderette Insurance Agency, Inc. Submission of your information constitutes permission for an agent to contact you with additional information about the cost and coverage details of health plans. Possible options include, but are not limited to Major Medical Plans, Short Term Plans, Dental Plans, Vision Plans, and more. Descriptions are for informational purposes only and subject to change. Insurance plans may not be available in all states. For a complete description, please call 1-866-639-1662 to determine eligibility and to request a copy of the applicable policy. Alderetteinsurance.com is not affiliated with or endorsed by the United States government or the federal Medicare program. We do not offer every Medicare plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. Our company complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability, or physical disability.
By using this site, you acknowledge that you have read and agree to the Terms of Service and Privacy Policy. Please read our privacy policy carefully to get a clear understanding of how we collect, use, protect or otherwise handle your Personally Identifiable Information in accordance with our website. Alderetteinsurance.com is privately owned and operated by Alderette Insurance Agency, Inc. Submission of your information constitutes permission for an agent to contact you with additional information about the cost and coverage details of health plans. Possible options include, but are not limited to Major Medical Plans, Short Term Plans, Dental Plans, Vision Plans, and more. Descriptions are for informational purposes only and subject to change. Insurance plans may not be available in all states. For a complete description, please call 1-866-639-1662 to determine eligibility and to request a copy of the applicable policy. Alderetteinsurance.com is not affiliated with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. Our company complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability, or physical disability.
By using this site, you acknowledge that you have read and agree to the Terms of Service and Privacy Policy. Please read our privacy policy carefully to get a clear understanding of how we collect, use, protect or otherwise handle your Personally Identifiable Information in accordance with our website. Alderetteinsurance.com is privately owned and operated by Alderette Insurance Agency, Inc. Submission of your information constitutes permission for an agent to contact you with additional information about the cost and coverage details of health plans. Possible options include, but are not limited to Major Medical Plans, Short Term Plans, Dental Plans, Vision Plans, and more. Descriptions are for informational purposes only and subject to change. Insurance plans may not be available in all states. For a complete description, please call 1-866-639-1662 to determine eligibility and to request a copy of the applicable policy. Alderetteinsurance.com is not affiliated with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. Our company complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability, or physical disability.