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Differences in Health Insurance Plans


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Health insurance plans have changed dramatically over the past ten years, and American's currently have several different options to choose from- including HMO's, PPO's, fee-for-service plans, MSA's and major medical. There are two main categories of health insurance plans that each of these policies is classified as; managed care plans and indemnity care plans. The differences between each of these plans mean the differences in how you will receive health care when you need it.

Managed care health insurance plans, mostly the HMO's, focus primarily on prevention, and people with these types of policies pay less for their coverage. The drawback is that you are limited to specific health care providers. Indemnity plans, also known as fee-for-service plans, will cost you more- but you are completely covered no matter what illness or accident might occur. Indemnity plans place an emphasis on patient choice, allowing you to choose where and when you are treated.

The newest options in health insurance plans include the PPO (preferred provider organization) plans. These are somewhat a hybrid between the managed care and indemnity categories. Due to their flexibility, these plans are becoming the most popular. PPO plans are similar to managed care plans in that they encourage preventative care, such as routine check ups which are covered under the plan, but you are allowed more of a choice over what doctors you can see.

So how do the different plans effect how you receive health care? When you are part of an indemnity plan, you are typically able to choose the doctor you want to see when an unexpected illness occurs. You will have to fill out paperwork to submit claims, and keep track of your receipts and medical bills. If you are covered under the managed care health insurance plans, you have a higher chance of having your routine check ups covered, since they believe strongly in preventative medicine. You typically are required to choose a health care provider from a list of participating providers, but most of the paperwork required to process your claim is the responsibility of the insurer.


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