A Quick Guide to Various Medical Insurance Terms
Your human resources director just gave you a huge packet of medical insurance information. Before you let out a small groan and throw the book to the farthest corner of your desk, it might be a good idea to look it over and see if you understand it fully. Keep in mind that this medical insurance someday just might help save your life.
There are a few medical insurance terms that can cause confusion, so here are some tips to help define and clarify some of the most common terms that you'll come across in a normal health insurance manual. Use this as a brief reference, but be sure to refer to your manual for further details.
Term # 1: Health Maintenance Organization (HMO)
Health Maintenance Organizations or HMOs are a form of popular group medical insurance. In this design, a group of doctors, nurses, pharmacies, and other medical professionals are hired by the medical insurance company to provide health care to the people that are covered by the plan. Normally the insured people must choose a primary care physician who coordinates all their care. An advantage of this system is that it keeps cost regular and relatively low. However, there is little room for flexibility.
Term # 2: Preferred Provider Organization (PPO)
This type of medical insurance is somewhat similar to the HMO, but does have a few marked differences. In this case, instead of the medical professionals being hired by the insurance company, the company enters into contracts with the doctors and other professionals to offer their services to the people insured either at a reduced rate, or as a part of a co-pay/co-insurance plan.
Term # 3: Medical Deductible
This is perhaps one of the most problematic medical insurance terms out there. It causes a lot of confusion because a lot of people just assume that the co-pay that they give their doctors is all they need to worry about. In fact, the medical insurance deductible acts like the deductible on your car insurance. In this case, you have to spend a certain amount of money before your medical insurance will start paying fully for your medical needs.
These are a few of the medical insurance terms that you probably will come across while looking into the possible choices. Make sure you understand the various terms and conditions of your specific medical insurance plan, and ask questions if you have any doubts.