Health Insurance Guide - Affordable Health Insurance In New Jersey Section

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Both health insurance programs cover a broad assortment of medical expenses; including hospital visits, surgical procedures, and partial hospital stays. Dental coverage is also provided by most health insurance plans plus reimbursement for prescription drugs.

Managed Care.

More than half of all American citizens have a managed care health insurance plan. Managed Care plans and participating providers vary but will often include: health maintenance organizations - HM0's, preferred provider organizations - PPO's and point-of-service - POS programs. The Managed Care policy is designed to offer coverage on an extensive assortment of health care services and also include financial rewards to policyholders for seeking care from health care professionals participating in the program.

Preferred provider organizations (PPO's) generally offer a wider choice of providers than HMO's. Premiums can be similar to or slightly higher than HMO's, and out-of-pocket costs are generally higher and more complicated than those for HMO's. PPO's allow participants to venture out of the provider network at their discretion and do not require a referral from a primary care physician. However, straying from the PPO network means that participants may pay a greater share of the costs.

Fee-for-Service.

These health insurance plans dictate that the health care or medical professional be paid a set fee for each individual service administered to the patient or policy holder. A doctor or medical practitioner of their choice can see the medical caregiver or the patient - health insurance policyholder, can file Health Insurance policyholders or Patients and the insurance claim.

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