I need help picking out a new insurance plan. It has to be a PPO so I don't get weighed down by all the bs my HMO plan is putting me through. suggestions are very much encouraged as time is of the essence
In general the PPO will cost more money than a HMO, but you have more choices. Hard to give advice as they vary I'm sure by state and region.
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In short if you didn't already know, PPO plans have doctors that are within a specified network of doctors, and according to which network you choose or are offered, are the doctors that you can seek treatment. The doctors get paid for each visit they see a patient and have virtually an unlimited amount of resources at their disposal. So these doctors want to see many patients and will take better care of their patients so they can get the "repeat" business so to speak.
An HMO plan, essentially has a group of doctors that you can visit, however, these doctors are paid a "salary" & a "budget" by the HMO, so they get paid no matter who they see. The more people they see in the beginning, the more resources and supplies they use up, so the people who visit the doctor in the latter stages of the year, the less resources the doctors have on hand to treat you with. Not stating that the doctors who belong to this plan are less effective, they just don't have all of the resources that the PPO doctors have.
As for plans, they come in all shapes and sizes. Some have co-pays for doctor visits and prescriptions, some don't. Some have low deductibles and some have high. Deductibles only have to be paid if you stay overnight in a hospital or have surgery, either outpatient, inpatient, or in the doctor's office. Some pay for physicals, some don't. However, according to how old you are, all plans must pay for a prostate screening for men over 50 (I think) and a mammogram for women over 50 (again, I think).
As for the cost of premiums, the rule is the higher the deductible ($1000, 2500, or higher) the lower the monthly payment. The lower the deductible, the higher the monthly premium. Also, if you have co-pays for doctor visits or prescriptions, the higher the cost also.
The reason for this is because the more the insurance company has to pay, ie the remaining balance for doctor visits & prescriptions, the more you will pay in monthly premiums. Most people (generalizing here) do not go to the MD for every cold, sniffle, or cut, scrape or pulled muscle. Most go only a couple times per year, so if this is your case, find a plan that only offers a few doctor visits per year and ditch the co-pay options. Or even, don't get a plan with doctor visits attached. Save the money you would have paid each month for the co-pays and pay for the MD visit yourself.
Anyway, hope this helps you out somewhat. There's a lot of policies with bells and whistles attached to them. Just review what's most important to you, and find an agent that will help you get what YOU want, not what the agent wants to sell you.