Pros and Cons of Health Insurance Plans

Post by Mei Ling Lin

Most American people get their health insurance coverage from their employers. Some people may plan to buy the health insurance. However, how well do you understand each plan? Do you know the advantages or disadvantages of your insurance plan? The main types of health insurance plan that you can choose include:

Indemnity plans – are the original health insurance plan, but fewer and fewer people are buying them these days because of their high premiums.
Pros: You can choose your own physicians and hospitals.
Cons: You must pay a $500 to $1,000 deductible before your insurer will pay your claims. You need to pay the difference, if your doctor charges more than the insurer consider.

HMOs (Health Maintenance Organizations) – are the least expensive and the least flexible health plans.
Pros: Low cost, usually $5 to $10 and not much paperwork involved
Cons: You can only visit doctors within a prescribed network of doctors, and must choose an in-network primary care physician who oversees your medical services, and you must get a referral from him or her to see a specialist.

PPOs (Preferred Provider Organizations) – are more flexible and cost a little more than HMOs.
Pros: payment is $5 to $10 and may visit an in-network specialist without getting permission.
Cons: You need to pay the bill and submit it to the insurer for reimbursement, if you see a non-network doctor. In addition, you may pay the difference between the non-network physician's bill and the network physician's bill would be.

POSs (Point of Service plans) – are more flexible and cost slightly more than PPOs.
Pros: You can visit a non-network doctor with your primary care physician's approval and still receive coverage.
Cons: You must pick a primary care physician to oversee your services. If your primary care physician does not approve your visit to a non-network physician, you may have to submit the physician's bill and only receive partial payment.