In Florida there are HMOs, PPOs, POSs, Open Access Plans, and Open Access HMOs. The majority of the health insurance companies in Florida are PPOs, which stands for Preferred Provider Organization. The PPOs in Florida include Humana (recently converted from an EPO), United Health One, and Coventry One. There are more of course but for our purposes the PPO’s that are listed here are the main health insurance companies and the other PPO’s like Avalon, Assurant, Time, Freedom, Mega, Midwest, etc. are not good or honest health insurance companies. Avalon is not a dishonest company but suffers from the unfair competition rules that make health insurance such a disastorus enterprise for our economy. The rest of these health insurance companies are prone to tricks involving coinsurance and benefit maximums on hospitalization. And for the love of god, stay away from anything owned by Health Markets (United American, Midwest, and Mega).
Managed Care: The Big One
Managed Care plans provide coverage for comprehensive health services to their members and offer financial incentives in the form of lower out-of-pocket costs to patients who use doctors participating in a network. More than half of all Americans have some kind of managed care plan – the three types include health maintenance organizations (HMO’s), preferred provider organizations (PPO), and point-of-service (POS) plans. Most of the other plans including EPO’s fall into the category of these three managed care types.
What is a PPO in Florida?
A PPO is a type of managed care health insurance plan that combines features of a fee-for-service plan and an HMO. In a PPO, members who seek care within the network of participating doctors and hospitals pay lower out-of-pocket costs. Members can also seek care from nonparticipating doctors and hospitals, but pay a higher portion of the cost of care.
What is a POS in Florida?
A POS plan is also known as Point of Service plan is also based on the basic managed care foundation: lower medical costs in exchange for more limited choice. Still, the POS is different than the HMO or traditional managed care plans in that even though technically upon enrollment you are required to choose a primary care physician to monitor your health care no POS plan in Florida that I know of actually does this.
What is an HMO in Florida?
An HMO, Health Maintenance Organization, is a type of managed care health insurance plan that allows you to receive care through a network of participating doctors and hospitals. Generally, you select a primary care physician who coordinates your care and refers you to specialists when needed. Out-of-network care is generally not covered under an HMO plan, unless the member requires care that is not available in the existing network.