Health Insurance Terms

 

Health Maintenance Organizations

  • Required to have a primary care physician that’s responsible for managing and coordinating health care
  • Must choose your doctors within the HMO network
  • Need a referral to see a specialist except in emergency situations but the specialist must be in network at well.
  • No coverage for any services that are out of network

Preferred Provider Organizations

  • A health plan that has contracts with a network of preferred providers that you can choose from.
  • You are not required to have a primary care physician and you do not need a referral to see a specialist.
  • You can choose any healthcare provider in a network and pay the co-payment and deductible but if you choose an out of network provider there will be higher costs.

Century Preferred Comp

  • It is a PPO plan that has varying levels of deductibles and coinsurance for all covered services.
  • Has a network of providers that allows you to receive health care for cheaper than using out-of-network providers.
  • No primary care physician referral required to see a specialist and all CT hospitals are in the network.

Point of Service

  • Is a combination of the HMO and PPO plans with varying benefit levels.
  • Required to designate a primary care physician who can make referrals to network specialists when needed.
  • You can go to out of network providers but with greater costs.

Health Savings Accounts

  • Savings account, that you contribute money into, that is used for health insurance costs.
  • Employer may contribute to your HSA but you get to decide what doctor you see and how the money is spent.
  • You must carry a high-deductible health plan to qualify for an HSA.

High Deductible Health Plan

  • This is a requirement for having a Health Savings Account plan.
  • Your deductible is higher than other insurance plans but your premiums are lower.
  • Once you meet your deductible your covered health care costs are paid by the insurance company

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