What Types of Ohio Health Insurance Policies are Available?
Ohio health insurance policies may be broadly classified as Indemnity Policies and Managed Health Care Policies. Each kind of policy has its own unique benefits and features. Choosing the right policy is a matter of getting a plan to suit requirements and budget constraints.
Types of Health Insurance Policies in Ohio
Ohio health insurance policies can be broadly classified as Indemnity Policies and Managed Health Care Policies.
An Indemnity policy allows you the freedom to consult a physician or a specialist of your liking without the need of referrals. You will be required to pay up front for medical services and then submit a claim to the insurance company for reimbursement. But this is only possible if you pay an annual deductible. The health insurance company will settle the claims at ‘usual, customary and reasonable’ rate (UCR rate) of a set percentage.
Managed Health Care Policy
There are basically three different types of Managed Healthcare Plans under Ohio health insurance. These are Health Maintenance Organizations policy, Preferred Provider Organizations policy and Point-of-Service policy. Each policy has its own unique features and benefits. Each plan also has its own set of restrictions. You need to compare these plans and determine which one meets your needs before selecting one.
· HMO (Health Maintenance Organizations policy) - This policy is the least expensive and involve low co-payments with almost no paperwork. It provides a list of physicians and hospitals for your healthcare. You are required to choose a Primary Care Physician (PCP) who would address almost all your healthcare needs. In case you need to be referred to a specialist, you need to obtain a referral from your PCP. The only disadvantage of this Ohio health insurance policy is that there would be no coverage if you choose to seek services of a specialist without a referral from your PCP.
· PPO (Preferred Provider Organizations policy) - Like the HMO, the PPO policy offers a network of providers. To begin with, you do not have a PCP if you opt for a PPO policy. You have the freedom to consult any physician given in the list or network of providers without the need of a referral. You can also choose to go out of the network of providers and consult specialists, but the financial benefits you receive will be lower. This flexible policy is more expensive than a HMO.
· POS (Point-of-Service policy) - This is a popular Ohio health insurance policy as it combines the qualities of HMO and PPO with benefit levels differing according to whether you receive your care inside or outside the health insurance company's network of providers. The advantage of this type of plan is that you can choose your PCP and retain the right to see physicians that are out-of-network. You do not have to pay an annual deductible before coverage begins. Plus, it covers preventive care. This policy is ideal for those who might require urgent medical care and do not want to be bothered with referrals and other restrictions.
Choose a Plan to Suit Your Needs
Health insurance companies have a wide array of health insurance plans. It is important to short-list plans and then choose a suitable and affordable Ohio health plan by carefully considering the individual benefits and restrictions of each. As there are many types of Ohio health insurance policies available, one should necessarily compare the quotes offered by leading Ohio insurance providers. The best way to do this is to find a knowledgeable health insurance agent with all the necessary resources to help you make an informed decision.
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ABOUT THE AUTHOR
The author has over 22 years of experience in helping clients find an appropriate Ohio health insurance plan that pertains to their case specific needs.