Thinking about expensive nature of medical treatment, the necessity to protect yourself, your loved ones and/or your employees with health insurance is important yet unfortunately insurance policy options may complex and confusing. Whether you’re looking for personal or group health insurance, the features of each plan listed below will help you find the best NH health insurance policy for Your Family or Company.HMO - Health Maintenance Organization Available to either individuals or business groups as well as employer teams, the Health Maintenance Organization (HMO) uses a Primary Care Physician (PCP) to guide all health care treatment. In this type of plans, services are provided by physicians and allied healthcare workers who are employed by or perhaps under agreement with the HMO. Except in the instance of an emergency, no benefits are available outside of the provider network. If you choose this type of prepaid, or captivated health insurance plan, individuals will pay a small fee every month to be a member of the HMO, as well as modest fees or copayments for specified health care services.
For major services, pre-authorization requirements must be fulfilled under this type of plan.
PPO - Preferred Provider Organization
Like the EPO, the Preferred Provider Organization allows you to self-refer to any provider inside the plan. Under this type of policy, doctors and hospitals agree to provide discounted prices to policy members, so when utilizing the in-network providers, you will receive a higher level benefit, which may be as much as 90 to 100 % after the deductible. For treatments received outside of the network, you will typically be refunded 60 to 80%, and these services usually have a lifetime maximum benefit for each member (ie: $1,000,000).Like the EPO, all in-network visits to the doctor, the emergency room and prescription drugs are usually covered for just a co-pay, and pre-authorization requirements must be satisfied in or out of network.
The main difference between the PPO and the EPO is that under an EPO plan, you generally do not receive any out-of-network coverage except in case of an emergency.
POS - Point of Service
Similar to an HMO in-network plan, a Point of Service (POS) plan utilizes a "gatekeeper" PCP to recommend cases to other in-network providers. As a Client, you are allowed to see either in-network or out-of-network providers, but you will pay more on your own when using an out-of-network specialist.
High Deductible Health Plans (HDHP)
Under a High Deductible Health Plan (HDHP), almost all covered services are subject to your plan’s insurance deductible except routine preventative treatment, which is covered in full. If you go for this type of health insurance plan, you generally will not be charged co-pays for office visits and prescription drugs. HDHPs can be either EPO or PPO plans and may be paired with an H.S.A. (Health Savings Account).
EPO - Exclusive Provider Organization
Another type of NH Health Insurance plan, the Exclusive Provider Organization or EPO, or Exclusive Provider Organization allows you to self-refer to any provider within the network. Similar to the HMO, there is no out of network coverage under an EPO health insurance plan other than in the event of an emergency. If you choose this type of policy, you will have protection for office visits, the Emergency room, as well as prescription drugs for only a co-pay. The annual contribution levels for the H.S.A.,as well as the insurance deductible and out of pocket maximums under the HDHP, are determined by the internal revenue service. Indemnity Also known as “fee-for-service” policies, indemnity health insurance plans existed mainly before the rise HMOs and PPOs, and provide traditional coverage. As an insured person under this type of plan, you are free to use the doctor, clinic, or hospital of your choice yet will pay a predetermined the cost of health care services, while your insurance company (or self-insured employer) will pay for the remaining charges. The costs related to these services will be determined by individual providers, and therefore vary from physician to physician. Under indemnity plans,a deductible commonly applies and there are generally no co-pays for visits to the doctor.