Ppo Health

• Whats the difference between PPO and an HMO?   Im a 22 year old male and am buying health insurance for the first time on my own, what should I do?
  • Hey there. I am a 22yr old female and I work in the insurance business and I myself just obtained health insurance for the first time. PPO is MUCH MUCH better as you can go to almost any doctor you want in the book you will receive with your policy. You can also go to any type of doctor, say like a Podiatrist, Bone Disease Doctor etc. Your co-pays tend to be a little bit more but it is a better deal in the long run as with an HMO if you ever have to go to a specialist doctor you would have to go to your main doctor, (pay the co-pay there), then get a referral to go to the specialist doctor, (podiatrist, bone disease, throat doctor etc), then you would end up paying another co-pay there as well. Go with an HMO!!! Any other questions feel free to email me!
  • A PPO plan lets you select the doctor or hospital you want from a list of heath care providers that are approved by the insurance company. With a HMO, you go to their facility and get whatever doctor has the duty.
• Health Insurance, United Healthcare Plan CoPay 35 PPO ?   Does anyone have this coverage and is it good, worth the money, any problems, etc.? Thanks!
  • A great book for you that I read is called "Healthcare for Less" by Michelle Katz...the book will help you sort through all of these questions and save you a ton of money in healthcare. Where you live in the country will effect your coverage and what your health insurance will cover....after I read the book, I found that an HSA was more cost effective for me and have saved sooooo much money!!!!! I got my copy of the book at Barnes and Noble. I think you can also order it cheaper on hope it helps you like it did me!!!
  • You probably would need to add more information about your plan so that we can see what the delivers. PPO plans are nice because you have more freedom than with an HMO. However, PPO plans are less likely than HMO plans to include preventive medicine like routine check-ups. Currently, Blue Cross Blue Shield has a family of plans called Tonik, which offers dental and preventive for a little more than what you?re paying. As for United Healthcare, it is one of the two largest health insurers in the US, and they get a favorable rating from PayerView, a group that measures how well insurers work with doctors (link below). I?ve also included links to some other sites that rate health plans and individual doctors and hospitals. You might also want to talk with local health insurance agents in your area. Try using MostChoice.com. It?s free and you can also get online quotes in a few minutes from many different local health insurance companies. You can find it here: Hope this helps, Barnes@MostChoice
• What is the best Health Insurance plan for me and my family? What should I look for?   I want to buy Health Insurance for me, my wife and my kid. I live in Minnesota. I can spend about 0-0 monthly for Insurance. What all I should look for? It is so confusing. PPO, Deductibles, Coinsurance, and all these plans... I know only a little, and it is very hard making a choice. Please Help!
  • I work for a health insurance company and I will tell you where insurance companies make their money...when you don't use your insurance. I'm not sure what the cost of the plans you looked at are (or why that other person said not to go with a HMO) but if you and your family are overall healthy then an HMO is probably your best and cheapest way to go. HMO means that you will have a primary care doctor or general practioner who will have to refer you to another doctor for "specialty" issues they can't/don't deal with. Example a cardiologist or dermatologist. You would go to your primary doctor for sick and routine physicals. The only downfall to this type of plan is that they are your PRIMARY CARE doctor and can chose who they will refer you to; most doctors will give you a few choices and may even take your suggestions if there is a doctor you would like to see but this all depends on the doctor. Some doctors are part of "groups" and will only refer you to someone in their group and this is generally something the doctor has agreed upon when joining that particular group. So your best bet is to ask if you have a doctor in mind of who you'd like to select. These plans you will usually pay a copay (say / for office visits) and thats it but alot of companies are now offering plans that come at a cheaper cost to you but you pay a deductible or have coinsurance for certain services say lab work or x-rays as an example. If your family don't frequent doctor's offices or emergency rooms I think this it the best bet. (its what I have) With a PPO plan you don't need referrals to specialists and usually has 2 levels of benefits. In network and Out of network. In means you are seeing a doctor that is a PPO provider out of network you can see anyone who is not a PPO provider but at a higher cost; usually a deductible and coinsurance. These plans however usually cost more than an HMO plan. Important things to know... Deductible- you are responsible for paying this amount before your insurance will pay for anything. (usually more for a family, example 00 per family member or 00 family maximum so you would not have to pay more than 00/no matter if there are two people on your plan or four; this is per calendar year so it would start again the following year). Some company offer high deductibles which you may want to be leary of because it will be like not having insurance at all! Coinsurance- cost sharing with the insurance company (80/20, 70/30) it all depends on the plan you chose but they will pay the higher amount. Copay- how much you pay per office visit (whether it be mental health or a regular office visit) Some plans contain a combination of the three...just look at the plans and ask for a breakdown of anything you're not sure about. They should be happy to explain any questions you have about what you're paying for. Feel free to email me if you have any other questions.
  • Well you can throw out what the previous answerer said because they clearly don't know the Minnesota marketplace. The Minnesota market is dominated by the big three Managed Care plans (HMOs): Blue Cross Medica Health Partners Among them, they have more than 90% of the market. They are going to be the cheapest. Everybody else is going to be more expensive because they don't have enough market share to get the same provider discounts as the Big 3, thus meaning they can't pass along the discounts to you in the form of lower insurance premiums. Now here's the bad news. If you don't get coverage from your employer's offerings, you are not going to have enough money in your budget to afford health insurance. 0 per month will not cut it. If you don't have an employer sponsored group plan that they are paying part of the premium, you are going to have to find coverage in what is called the "individual market" which means you don't get a group discount and worse.....you have to pay 100% of the premiums. Typical family plan coverage in the individual marketplace in Minnesota runs more than 00 per month. You are probably going to be best served by buying an HSA or Health Savings Account. It has two pieces....a High Deductible Health Plan (HDHP) and a cash account. You should pay the premiums on the HDHP and stash as much cash as you can into the cash account. Routine preventative care is provided by the HDHP with just a small copay. When you get sick and need to be seen by a provider, you pay cash out of the cash account until you hit your annual deductible at which point the HDHP takes over. Each year you don't spend the money, you can roll it over to the next year and so on and so on. Because the cash account can grow to be substantial if you don't use it, you will have enough eventually to begin putting it into decent returning investment vehicles and get more bang for your buck, so to speak. Eventually, you may work for an employer that will contribute an annual amount to your cash account, this will roll over from employer to employer because you own the account, not your employer. You can take out the cash for medical expenses tax free and when you turn 65 you can convert the account to a retirement account and spend the money on whatever you want and pay only your post retirement tax bracket rate on the accrued gains. But because you are paying your own cash for your care, you are likely going to shop around a bit for providers who give good care but don't charge an arm and a leg for it, which makes you a smarter health care consumer and lowers the overall cost of health care to the rest of us. HSAs are sold not only by the Big Three Health Plans, but by a number of competitors including traditional indemnity health insurers (like Aetna, Assurant, etc.) and even banks and other financial institutions. HSAs really are the wave of the future and you are getting in early....so consider yourself lucky and take advantage early on.

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