Health Maintenance Organizations (HMO)
An HMO gives you a range of benefits for a prepaid monthly fee. The plan focuses on wellness, prevention, and treatment within a network of providers. Out-of-network providers are usually not covered, unless in an emergency.
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Preferred Provider Organizations (PPO)
PPOs often have a larger network of providers. This option can offer the greatest flexibility for members seeking care in and out of network. If a member visits an in-network doctor, they’re only responsible for their annual deductible and copay. If a member gets care outside the network, benefits may be reduced and their copay may be higher. Often, annual deductibles for PPO plans are higher than deductibles for HMO plans.
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Short-Term Health Plans
Short-term health plans are designed to help keep you covered while you are in between plans from your employer, Healthcare.gov, or a private insurer like Scott & White Health Plan. A short-term plan typically provides basic coverage for health emergencies and catastrophic events. Short-term plans can be purchased for periods ranging from 1-11 months.
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POS — often referred to as the “self-referral option” — is sometimes offered in conjunction with HMOs. Members can see either in- or out-of-network providers at the point where they choose to receive medical services. This option gives members freedom of choice to self-refer to non-contact providers.