Apr
27
People that work for small companies or groups are usually offered various medical coverage choices by the company they work for. The insurance covers just about everything, from visits to the doctor to prescriptions to emergency room trips, etc.
To assist owners of small business decide on which type of small business health plan best matches the company budget, as well as the requirements of those that work for them, the following is guidance relating to the various types of plans on the market.
Indemnity plans - These main insurance plans usually include a deductible. The insurance company will start to pay the benefits after the deductible has been met. Once the medical costs go past the deductible amount, benefits are generally paid as a portion of the actual expenditures, generally around 80%. This type of coverage generally offer the most flexibility when it comes to choosing where to go for medical care.
Health Maintenance Organization (HMO) plans - This type of health insurance for the self employed plans usually allows the insured individual to choose on a PCP (Primary Care Physician) from a directory of network authorized providers. The PCP is the one that handles the health care of the insured person. If the covered person requires special care from a provider not in the network, they need to get a referral directly from their PCP.
The person insured needs to receive treatment from a network provider so as to receive payment from the HMO.
PPO, or Preferred Provider Organization plan - This kind of coverage is characterized by the insurance company making a contract with chosen doctors and medical facilities to offer treatment at reduced prices. If you are a PPO member, you can seek health care from a hospital or physician who is not from your network, but a copayment, or larger deductible, will be required.
Point of Service (POS) plan - This plan is a combination of a PPO and a HMO, only this one is more adaptable than HMO plans, but you still need to pick a primary care physician. Similar to PPO, you can get medical service from a facility or doctor not belonging to the network, but it is going to cost you more. However, if a primary care doctor gives you a referral, POS will compensate the cost.