Health insurance is basically a kind of insurance which covers medical expenses which arise as a result of an accident. These expenses can be related to hospitalization costs, cost of medications or even doctor's visit charges. These expenses can only be submitted to a health insurance firm before they are paid directly by the employer. This direct payment is the major difference between health insurance and health maintenance organization (HMO) insurance.
HMO medical plans cover the health expenses only for a specific period and at a specific health insurance provider. HMO plans do not provide any coverage for pre-existing illnesses. It means if you get sick during the grace period and you miss the payment, then you will have to suffer the consequences.
PPO is another kind of health insurance coverage, which offers more flexibility than HMOs. This plan enables their subscribers to have a flexible medical expense reimbursement option. A good example of this is the flexibility of the time when the medical expenses must be reimbursed. The subscriber may choose to reimburse the medical expenses up to the next pay day, for as long as there is no hospital stay required.
Medicare is basically a federal program, which was put in place by the government to provide for the financial needs of old age people. Unlike Medicaid, which provides programs for the needy only after they fall below a particular income level, Medicare provides coverage even for those who fall below a particular income level as long as they meet certain requirements. Medicare Supplement Insurance provides additional coverage for some of the ordinary medical needs that are not provided for by the original Medicare program. For instance, the good health insurance plan provides coverage for outpatient visits, surgical expenses and minor dental care.
The primary difference between HMO and PPO is that HMO is restricted to be taken by members of the HMO network. A member need only to visit the health insurance provider's office for enrollment or he will be covered by the health insurance plan. On the other hand, a PPO requires the potential member to first acquire a Medicare Part A and Part B coverage before he or she can enroll in the health insurance plan. The good part about PPOs is that there are still many people who do not have Medicare, so they can choose this kind of health insurance plan as an affordable care act coverage for them.
Another difference between HMO and PPOs is the deductibles that must pay. There is usually a monthly fee for each member to pay for the healthcare deductibles. The monthly fee may differ from one health insurance plans to another, but it is minimum for every member to pay. There are some PPO health insurance plans that require you to pay deductibles only for the first 30 days, once you have met the requirement, you can settle the bill after that.
One more difference between HMO and PPO is the co-pays. In PPO, a health insurance company may reimburse your medical care costs up to certain limit depending upon the coverage that you already have. In HMO, your medical care costs are solely responsible. If you visit the doctor frequently and you meet the deductible requirements, you don't need to pay for your medical care costs at all. Although HMOs have fewer restrictions on the charges you need to pay, most of them have a co-pay which is the amount you have to pay before your medical care expenses will be covered by the insurance company.
HMO and PPO health insurance plans have some similarities and differences, but both have their own benefits and disadvantage. If you think you are in need of one, you must evaluate and analyze the pros and cons. Make sure you have a thorough understanding of the health insurance plan, its costs, the deductibles and co-pays. If you are still undecided, you can ask for referrals from friends or family members who have already acquired one. You can also browse online to see which type of health insurance plan is suitable for you.