Coventry Health Insurance of Georgia (GA) | Health Insurance Georgia | HMO vs. PPO vs. POS health insurance Georgia Plans

Health Insurance Georgia

HMO vs. PPO vs. POS health insurance Georgia Plans

One of the most difficult parts of making a decision about a health insurance Georgia policy is determining which kind of plan to get. The three main categories of health insurance Georgia plans are HMO, PPO and POS. They vary based on flexibility and amount of freedom and choice in physicians. That of course will have an effect on the monthly premium costs. However, Each kind of health insurance Georgia plan has advantages and disadvantages, so you will want to know the main differences in order to make the best educated choice when purchasing an individual health insurance Georgia policy for you and your family.

A Health Maintenance Organization plan, better known as an HMO, is typically the least expensive type of health insurance Georgia plan. It tends to have less physicians and health care providers included in its network because the negotiated reimbursement rate is typically lower than it is for other types of networks. An HMO health insurance Georgia plan requires that each member declare one doctor as the Primary Care Physician (PCP). That PCP will then oversee all medical services performed. If the member needs to see a specialist or a different doctor, the PCP must write a written referral in order for benefits to be payable for office visits to another specialist. Some people find this requirement to be too restrictive and time consuming. However, it may be beneficial for an individual with a complex medical history, or chronic illness, to have one primary doctor supervise all other visits and all medical care. In this manner, that doctor can make sure that services are not being duplicated, and that no treatments will conflict with each other. It may also be helpful to individuals that prefer getting to know one doctor well, and having that one physician become familiar with their particular case.

A Preferred Provider Organization plan is known as a PPO health insurance Georgia plan. This is one of the most popular types of health insurance Georgia plans out there. The reason for that is that it is moderately priced, and includes a large network of physicians and health care providers. Most doctors' offices will join the PPO network of the major health insurance Georgia carriers. Therefore, it is probably that whatever doctor you choose will be a participating provider for your particular health insurance Georgia plan. However, a PPO health insurance Georgia policy will still pay out benefits, even if you go to a physician that it not a part of its network. The benefits will be smaller, and you may have a higher deductible, but there will still be benefits. An HMO health insurance Georgia plan does not pay any benefits for out of network visits. There is no requirement for designated a PCP, and usually referrals are not needed. However, that is not to say that you will not occasionally need prior authorization. You will want to read your particular health insurance Georgia PPO policy to determine when you need prior authorization. This is different from a referral in that you do not have to get it from a physician. You merely have to call up the number on the back of your card to receive authorization for certain services.

A Point of Service plan, referred to as a POS health insurance Georgia plan does not require that you see a network doctor. So these plans are the most flexible and give you the most choice. Typically, they have higher monthly premium charges.

Keep in mind the different types of health insurance Georgia plans, HMO, PPO or POS, to determine which is best for you.

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