These days, when you choose your health insurance, chances are it will be a form of managed care. Managed care is the most popular type of health insurance these days, and understanding the different types of managed care is vital to making an educated choice. At W.B. Adams Company in Beaverton, OR, we can provide the information you need to make the correct decision.
Before understanding the types of managed care, it is important to understand how provider networks, drug formulary, and deductibles affect all types of health insurance.
HMO
The Health Maintenance Organization is the original type of managed care that resulted from the Health Maintenance Organization Act of 1973. It opened the door to a whole new wave of healthcare insurance. With an HMO, you must have a primary care doctor who manages your care. Our primary care doctor must be in the network, and if you need to go to a specialist, they will need to give you the necessary referral. Visits outside the network are not covered except in an extreme emergency. An HMO is the most restrictive type of managed care but also the most affordable.
PPO
A Preferred Provider Organization is a much more flexible option. You will have a primary care physician, but you will not need them to refer you to a specialist, whether within or outside the network. You will pay less for a visit when you stay in the network, but you can visit anyone.
POS
The Point of Service combines the best points of the other types of managed care. You don’t need a referral as long as you stay in the network.
Contact our office at W.B. Adams Company in Beaverton, OR, when you need help choosing a healthcare provider or have questions about managed care. Give the office a call today.