Fee-For-Service (or Traditional Medical
This is the traditional kind of health care policy.
Insurance companies pay fees for the services provided to the insured
people covered by the policy. This type of Medical Insurance offers
the most choices of doctors and hospitals.
Health Maintenance Organizations (or HMOs)
Health maintenance organizations are prepaid
health plans. As an HMO member, you pay a monthly premium. In
exchange, the HMO provides comprehensive care for you and your family,
including doctors' visits, hospital stays, emergency care, surgery,
lab tests, x-rays, and therapy. The HMO arranges for this care either
directly in its own group practice and/or through doctors and other
health care professionals under contract. Usually, your choices of
doctors and hospitals are limited to those that have agreements with
the HMO to provide care.
Preferred Provider Organizations (or PPOs)
The preferred provider organization is a
combination of traditional fee-for-service and an HMO. Like an HMO,
there are a limited number of doctors and hospitals to choose from.
When you use those providers (sometimes called "preferred"
providers, other times called "network" providers), most of
your medical bills are covered. When you go to doctors in the PPO, you
present a card and do not have to fill out forms. Usually there is a
small co-payment for each visit. For some services, you may have to pay
a deductible and coinsurance. As with an HMO, a PPO requires that you
choose a primary care doctor to monitor your health care. Most PPO's
cover preventive care. This usually includes visits to the doctor,
well-baby care, immunizations, and mammograms. In a PPO, you can use
doctors who are not part of the plan and still receive some coverage.
Many people like this option because even if their doctor is not a
part of the network, it means they don't have to change doctors to
join a PPO.
In Network Only
In/Out Of Network
Employer and Employee Paid
For groups over 5 employees, please fax your census to