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Understanding your health care plans can be confusing. Have you ever wondered what all that verbiage means?
Health plans come in a variety of acronyms (HMO, PPO, and HSA). Those your employer is most likely to offer include:
HMO– Health Maintenance Organization plans. These managed care plans offer the best pricing and the least flexibility. They serve up lower prices by limiting your care to the doctors, clinics, and hospitals within the HMO’s network. HMOs also require you to choose a primary care physician (PCP) who coordinates your health care and provides you referrals before you are able to visit other network doctors. Go outside the network and your services won’t be covered.
PPO– Preferred Provider Organization plans. Like HMOs, these plans offer networks of doctors, hospitals, and clinics that are deemed “preferred providers.” By going to them you get lower rates negotiated by the insurance company. PPOs provide more flexibility than HMOs because they allow you to seek care outside the network which will likely cost you more in deductibles and co-pays. Unlike HMOs, PPOs don’t require you get a doctor referral before you see a specialist. Many of the plans, however, do require prior approval for certain expensive services.
POS-Point of Service plans. Try to think of these as hybrids between HMOs and PPOs. Like an HMO, you’re required to choose a primary care doctor to oversee your medical needs. But like a PPO, you’re allowed to seek care out of the network if you’re willing to pay a bit more. These plans also pay for treatment outside the network when your primary care physician refers you for such care.
FSA-Flexible Spending Account- FSAs allow you to set aside pre-tax dollars for certain health and dependent-care needs. For example, the money can be used to pay for deductibles, prescription co-pays, and other treatments not covered by your insurance. A big downside for many is that whatever you don’t use by the end of your company’s benefits year, you’ll be forced to forfeit.
HSA-Health Savings Account.-HSAs are tax-preferred savings accounts usually paired with high-deductible health plans. Employers and employees are allowed to contribute to them. HSAs allow you to set aside tax-free dollars to pay for routine, out-of-pocket health expenses. You also get an IRS deduction for the amount you contribute to the account each year, and you pay no federal taxes on interest earned by your HSA as long as you use the money to pay for eligible medical expenses as defined by the IRS. Dental and vision are included. Another plus: unlike an FSA, HSA funds roll over annually and accumulate, even if an employee changes jobs.
Deductible-The annual amount a consumer must pay before the insurance company will pay any expenses. Deductibles vary by plan. Typically, the lower-premium plans have higher deductibles you must meet before your insurance carrier is obligated to pay.
Premium-The monthly fixed payment charged by the insurance company for your plan, whether or not you use any health care.
Copayment-This is the fixed dollar amount you’ll pay under your plan for a particular medical service and for drug prescriptions. The insurer is responsible for the balance. The amount varies by plan.
Coinsurance-The percentage of the cost of medical services you’re required to pay beyond your annual deductible.
Footprint ID is an online digital health record that provides 24 hour access to your medical records and other pertinent documents to anyone you choose from anywhere. It’s easy to use and once you have made your final plan selection save your final copy here!
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