Find the Pennsylvania Health Insurance Plans Right for You
Pennsylvania health insurance plans are available in various formats but most health insurance packages will belong to one of three main categories. The main categories are Health Maintenance Organization (HMO) plans, Preferred Provider Organization or PPO plans and Indemnity plans, each with unique benefits and restrictions. Each of these coverage plans offers acceptable levels of health coverage for most of us, but the plans differ in requirements and restrictions, approved health providers and pricing.
In an HMO plan, only health care received from a network-affiliated health care provider will be covered under the plan, and all specialized care must be referred by your primary physician in order for the services to be covered. With PPO coverage, health care is covered at a higher percentage when you use a network provider with negotiated in-network rates, but you may also use out-of-network providers and receive a lower percentage reimbursement of your covered expenses. With an Indemnity type of insurance plan, you may use any health care provider you wish, and you should be covered for a set percentage reimbursement of your covered health expenses. Among these programs, HMO plans will have the lowest pricing rates, while Indemnity plans are very comprehensive and come with the most expensive premiums.
When choosing among an HMO, PPO or Indemnity plan, you should decide first whether your preferred physicians, labs and hospitals participate as part of the HMO or PPO network. Next, you should evaluate how much freedom you might prefer in choosing specialists should you require one. Finally, you should consider the trade-off between having more freedom in choosing physicians, specialists, labs and hospitals versus the significantly increasing premium prices associated with having greater flexibility.