Types of Insurance

Question 1

HMO (Health Maintenance Ogranization)

Answer 1

Requires patient to choose pcp, recieve referalls for specialist, but generally has lower out of pocket and predictable costs. (Limited network of providers, limited/no out of network coverage)

Question 2

PPO (Preferred Provider Organization)

Answer 2

Offers more flexibility in choosing healthcare providers, but may come with higher out of pocket costs. No need for referrals, better out of network coverage. (less predictable/higher costs)

Question 3

ACO (Accountable Care Organization) (model of delivering care NOT insurance)

Answer 3

Network of healthcare providers that work together to coordinate and provide care to patients with focus on improving the quality of care and reducing costs through coordinated and preventative care.

Question 4

POS (Point of service)

Answer 4

Similar to HMO, but allows patients to see out-of-network providers for a higher cost. Also requires a primary care physcians and referrals to specialists.