Group Health Coverage

Group Health Coverage. What are the best group health insurance coverage options available? Specialist recommendations.

Group Health Insurance Coverage: Health Maintenance Organizations (HMOs)

Health Maintenance Organizations are a form of managed care – you choose a primary care physician (PCP) from a roster of participating doctors. Subsequently, any specialist you see needs to be within the HMO network, and you first need to get a referral from your PCP. You will also be limited in terms of the hospitals that the insurance covers.

However, your monthly insurance payments already covers surgeries, diagnostic tests, hospital stays and emergency hospital visits; all you have to pay for each visit or procedure is a co-payment of five to ten dollars.

Group Health Insurance Coverage: Point of Service Plan (POS)

Similar to a HMO, the Point of Service plan allows you to choose a PCP and other specialists from a network of doctors. However, unlike the HMO plan, the POS plan allows you to see doctors outside the network. But your coverage will only cover a portion of the bill – you will have to pay more (including a higher premium), in order to enjoy the flexibility.

Group Health Insurance Coverage: Preferred Provider Organizations (PPOs)

The Preferred Provider Organizations plan gives you even more freedom compared to either a HMO or a POS plan. This eliminates the hassle of having to get referrals, and is very helpful if your condition requires you to see specialists frequently. However, you will thus also have to pay a higher premium.

High Deductible Plan plus HSA (Health Savings Account)

These plans usually require at least $1000 in payments before the health insurance kicks in. However, their premiums are lower, and this type of insurance can be financed by a health savings account.

Launched in December 2003 with congress approval, HSA allows you to invest pre-tax money to cover all manner of health care cost. Subsequent withdrawals for medical expenses are also tax-free. Unlike Flexible Spending Accounts (FSAs), your balances do not automatically expire at the end of each year. They are rolled over to the next and can continue to be used.

There are several good group health coverage options available. Choose the best for you based on your specific circumstances, for each health insurance option caters well to different needs.

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