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What plan types are there? There are several different types of managed-care health insurance plans. These include HMO, PPO, POS & HSA plans. Managed-care plans typically make use of healthcare provider networks. Healthcare providers within a network agree to perform services for managed-care plan patients at pre-negotiated rates and will usually submit the claim to the insurance company for you. In general, you'll have less paperwork and lower out-of-pocket costs with a managed care health insurance plan and a broader choice of healthcare providers with an indemnity plan.
What is a PPO plan? As a member of a PPO (Preferred Provider Organization) plan, you'll be encouraged to use the insurance company's network of preferred doctors and hospitals. These healthcare providers have been contracted to provide services to the health insurance plan's members at a discounted rate. Typically you won't be required to pick a primary care physician but will be able to see doctors and specialists within the network at your own discretion. You will probably have an annual deductible to pay before the insurance company starts covering your medical bills. You may also have a co-payment for certain services or be required to cover a certain percentage of the total charges for your medical bills. With a PPO plan, services rendered by an out-of-network physician are usually covered at a lower percentage than services rendered by a network physician. What is an HMO plan?
What is an HMO plan? Though there are many variations, HMO (Health Maintenance Organizations) plans as a rule enable members to have lower out-of-pocket healthcare expenses but also offer less flexibility in the choice of physicians or hospital than other health insurance plans. As a member of an HMO, you'll be required to choose a primary care physician (PCP). Your PCP will take care of most of your healthcare needs. Before you can see a specialist, you'll need to obtain a referral from your PCP. With an HMO you'll likely have coverage for a broader range of preventive healthcare services than you would through another type of plan. You may not be required to pay a deductible before coverage starts and your co-payments will likely be minimal. With an HMO plan, you usually won't have to submit any of your own claims to the insurance company. However, keep in mind that you'll likely have no coverage whatsoever for services rendered by non-network providers or for services rendered without a proper referral from your PCP.
What is a POS plan? A POS (Point of Service) plan combines some of the features offered by HMO and PPO plans. As with an HMO, members of a POS plan are required to choose a primary care physician (PCP) from the plan's network of providers. Services rendered by your PCP are most often not subject to a deductible. Also, like HMOs, POS plans typically offer coverage for preventive care visits. Typically, however, you will only receive a higher level of coverage for services rendered or referred by your PCP. Services rendered by a non-network provider may be subject to a deductible and will likely be covered at a lower level. If services are rendered outside of the network, you'll likely have to pay up-front and submit a claim to the insurance company yourself.
What is an HSA? Legislation establishing Health Savings Accounts (or "HSAs") took effect on January 1, 2004. HSAs and HSA-eligible health insurance plans are becoming more and more popular. Here are the basics: ? An HSA is a tax-favored savings account that may be used in conjunction with an HSA-eligible high deductible health insurance plan to pay for qualifying medical expenses. ? Choosing an HSA-eligible health insurance plan may help you save money. As a rule, the monthly premium on an HSA-eligible high deductible plan is less expensive than the monthly premium for a lower-deductible health insurance plan. ? Contributions to an HSA may be made pre-tax, up to certain annual limits. ? Funds in the HSA may be invested at your discretion. Unused funds remain in the account and accrue interest year-to-year, tax-free. Not all high-deductible plans are eligible for use in conjunction with an HSA.
When can I purchase a health insurance plan? You can purchase a health insurance plan for yourself and your family during the Open Enrollment period each year which usually runs from November 1st through January 31st (of the following year). Or anytime during the year if you qualify for a Special Enrollment due to a life changing event like getting married, having a baby, losing your health insurance coverage through your employment, moving to a new state or for other qualifying life events.
Will using this service cost me anything? All the services offered by are provided at no extra cost to you, the consumer. If you buy a health insurance plan via, you'll pay the regular monthly premium to the health insurance company you chose, but you'll pay nothing to us. Our fees are paid by the insurance companies in the form of commissions, which are built into the premium amount.
Do you have the best prices? Health insurance premiums are filed with and regulated by the California Department of Insurance. Whether you order through, directly through an insurance company or another local agent, you'll pay the same monthly premium for the same plan. This means that you can enjoy the advantages and convenience of online ordering by purchasing your health insurance plan via along with the availability of personalized service and rest assured that you're getting the best available price.
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