Understanding the type of care provided through your health care policy can be complex. All the different types of managed care have different rules, and you need to do different things to get services covered. At Kalare Tech in New Windsor, NY, we are independent insurance agents who work for our customers and will do our best to guide you through all the intricacies of managed care.
Health insurance policies offer three major types of managed care: HMO, PPO, and POS.
HMO
HMO stands for Health Maintenance Organization. This type of healthcare plan is the most restrictive. You will receive a list of participating healthcare providers that you can use. Your preferred doctor may or may not be on the list. You will need to choose a primary care physician who will coordinate your healthcare. You will need to get all healthcare within the network except in the case of an emergency.
PPO
PPO stands for Preferred Provider Organization. This type of managed care allows for a lot more flexibility. You pay the least if you remain in the network, but you can see any healthcare provider that you desire. You don’t need to get a referral to see a specialist.
POS
POS stands for Point of Service. It is not as restricted as an HMO but not as flexible as a PPO. It actually allows you to choose which one you want, HMO or PPO, on each occasion. However, you will need to get a referral to see a specialist, so you need to have a primary care physician.
Contact our dedicated team at Kalare Tech in New Windsor, NY, to help you understand your managed care options and choose the right coverage choice.