Insurance Lesson Hunter Cooley 4 th period

Types of insurance HMO (Health Maintenance organization) you must choose a primary care physician, frequently called a PCP, from a list of physicians who are part of the HMO network. You pay a monthly premium, and in return the HMO covers costs associated with preventative care, such as checkups and immunizations, as well as medical treatment, such as hospital stays, surgeries and lab tests. PPO (Proffered provider organization) operate similarly to HMOs, but PPOs offer more flexibility. You can choose a PCP from outside the PPO network, but you must fill out additional paperwork and pay for a larger portion of the medical costs. You do not need a referral from your PCP to visit a specialist as long as the specialist is part of the PPO network. POS (Point of Service plans) Similar to HMO and PPO plans but offer the most flexibility. POS plans cover most costs, even if your PCP refers you to a specialist "out of network." You can get some coverage--restrictions might apply--even if you refer yourself to a specialist outside the network.

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