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Healthcare Not having healthcare insurance could put you and your family at risk of being one injury or diagnosis away from bankruptcy. According to the Department of Health and Human Services, statistics show that lacking health insurance poses a greater risk of financial catastrophe than lacking car insurance or homeowner’s insurance. One of the primary purposes of health insurance is to protect against the risk of incurring unaffordable medical bills. Although people are 50-percent more likely to have car accident than to be hospitalized in a given year, the average bill for a hospital visit is over two and a half times higher than the average loss for a car accident. And, while the bill for a single hospitalization is about the same as the average loss from a house fire, a person is ten times more likely to be hospitalized than to experience a house fire. The Affordable Care Act: What Does it Mean for You? The Affordable Care Act was signed into law on March 23, 2010 and has drastically changed the face of healthcare – and impacted nearly every American. Find out more about the new health care reform and what it means for you HERE.
HMO The best way to determine which plan is best for you and your family is to learn what the difference is. Both of these plans are types of managed care -- HMO stands for Health Maintenance Organization and PPO stands for Preferred Provider Organization (There is also a 3rd, but lesser used organization known as a POS – Point of Service). All forms of managed care plans work with doctors, hospitals, and other health care providers, including your pharmacy and labs where you’d go for blood work. All of these health care providers make up the “network” within your health plan. HMO plans will have you choose a primary care physician (PCP) who will coordinate all of your ongoing healthcare needs. If you need to see a specialist for a need outside of the scope of the PCP, they will need to furnish you with a referral to see that specific provider. Within an HMO, you will almost exclusively be using in-network providers. PPO The most significant difference between an HMO and a PPO is that in a PPO you do not need to choose a primary care physician. You will be able to pick and choose your doctors and clinics from a “preferred” list, provided by the PPO plan. You also have the ability to go “out of network” and visiting a provider outside of the plan’s network for a higher rate of service. HMO’s tend to be more affordable than PPO plans, simply because they are more restrictive. You will pay less for your premiums, and will generally have smaller copays for services, but you must follow procedure and go through your PCP. A PPO plan has more leniency and flexibility, but premiums and copays can be higher, as well as having deductibles for some plans. So which should you choose – an HMO or a PPO? Well, that choice is entirely up to you. It’s important for you to do your research and consider your family’s needs. Links
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