HMO or PPO

[certherfbeef]

Health Maintence or Preferred Provider?

Ya'll had some opinions of whole or Term so I thought I'd see what ya might come up with on the health insurance side of things.

 

[Crowderfarms]

Health Maintence or Preferred Provider?

Ya'll had some opinions of whole or Term so I thought I'd see what ya might come up with on the health insurance side of things.

Cert, IF you can afford it, go with an HMO!!! You can go to Doctors that YOU want to go to, not one's that a PPO assigns you to, or directs you to. I have little faith in the Medical Profession to start with, but an HMO gives you better coverage. IMHO, but it will cost you more in premiums.

 

[msscamp]

Health Maintence or Preferred Provider?

Ya'll had some opinions of whole or Term so I thought I'd see what ya might come up with on the health insurance side of things.

Depends on who the insurance companies are. I've had both HMO coverage and PPO coverage and there was not much difference in how each worked. I don't know if my coverage was the exception, but I have never had any insurance company assign me a physician - I've always been able to choose from a list they provided.

 

[la4angus]

I have never had any insurance company assign me a physician - I've always been able to choose from a list they provided.

Same here.

 

[Crowderfarms]

I have never had any insurance company assign me a physician - I've always been able to choose from a list they provided.

Same here.

It may vary from State to State, but many PPO's here have a list of Physicians in their network, that you can go to. HMO's routinely, let you go to the Doc of your choice. At least that's been our experience. Knock on wood, I have not had to use my policy except for routine maintainance.

 

[msscamp]

I have never had any insurance company assign me a physician - I've always been able to choose from a list they provided.

Same here.

It may vary from State to State, but many PPO's here have a list of Physicians in their network, that you can go to. HMO's routinely, let you go to the Doc of your choice. At least that's been our experience. Knock on wood, I have not had to use my policy except for routine maintainance.

I have not worked nor been insured in Tennesee, but every other state I've worked in (and there are several) and had HMO coverage I had to choose a physician from a list. If I chose to go to a dr. that was not in the HMO's network, my insurance reverted to major medical and paid 80% after the deductible was met.

 

[norriscathy]

ANY health insurance between 55 and 64 is unafordable. $500 deductable with 20% copay is $1,800 per month in my group! $5,000 deductable is ONLY $1,300 per month! If your are self employed, health insurance is almost an impossibility!!!!!!!!!!!!

 

[mitchwi]

Why is it you never hear of an insurance company going broke?

Why is it the medical industry will give discounts if you have insurance, but if you don't they will charge you the highest possible price?

Why is it they can amend or drop someone from a policy at any given time to suit their statistic paradigm?

Why is it so many people worry about submitting a claim to insurance because they are worried how it will reflect on them in the future (medical, auto, home, etc) for fear of being dropped? so, they pay for it themselves...isn't that why we have insurance???

Sorry, IMO, insurance companies rate only the slightest notch above lawyers..........

 

[buckaroo_bif]

don't have insurance...

 

[Just_a_girl]

In my location, many doctors prefer PPO. Less of a pain.

I have PPO and I can go to any doctor I want. Only thing is, my company is small and most of the employees have insurance through their spouse, so those of us that have insurance get a heavy copay and deductible......my copay is $30 per office visit, $3000.00 deductible + a patient% for hospital stay or surgery.

But it is almost impossible to be without insurance. You spend the night in the hospital for observation and that could cost a nice $6000.00. That's hopsital only and does not include the fee for the doctor that came in, checked your temp, and said hello to you while you were in the hospital.


Got to watch those plans with an annual maximum too.

On HMO, I would have to select a PCP and stay with that PCP or get charged an out of network charge if not approved by my PCP, or the HMO plan. You can't just drop into the ER without it being approved either.

There are doctors that treat cash patients and give discounts, but the doctors try to guide these patients without insurance to a county clinic for needed shots to help out. I know for a fact that children's immunizations and routine visits can cost a big chunk, and you wouldn't believe the cash patients that won't go to the clinic because they are embarrassed to be seen there.

If you are self-employed the you might want to check into a plan without "routine care."

 

[la4angus]

Ours was $92.50 every 2 weeks and has gone up to $109.50 on Jan 1 2006. That is 20% deductible and $20.00 doc visit co pay. $15.00 for 90 day name brand prescription or as low as $8.00 generic 90 day prescription drugs.
We're satisfied. This also takes care of eyes and dental. I don't know the details there.

Over $100,000.00 plus Dr. charges in 2005 and I paid less than $500.00 out of pocket with my other insurance kicking in when the first one left off.

 

[Susie David]

Don't know about your area but in some places folks with the HMO are stuck with the docs that are employed by the HMO.
Get a doc that can speak english as a primary language.
We have a PPO and have maintained our same doc for years, Susie was his nurse years ago so we have confidence in him.
Weigh the benefits of coverage and what is allowed on various procedures. DMc