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HMO
(Health Maintanence Organizations)
A health care financing and delivery system
that provides comprehensive health care for subscribing members
in a particular geographic area using managed care techniques.
Most HMOs require that you only utilize physicians within
their network, often going so far as
PPO (Preferred Provider
Organization)
An organization where providers are under contract to an
insurance company or health plan to provide care at a discounted
or negotiated rate. Typically, you can see any doctor in the
PPO network without requiring special approval, and you usually
do not need to choose a primary care physician. Most PPOs
will also allow you to seek care outside of the PPO network;
however, the benefits are usually reduced and the insured
has a greater out-of-pocket expense.
Primary Care
Physician
A general or family practitioner who serves as the insured's
personal physician and first contact with a managed care system.
The PCP will usually direct the course of your treatment and/or
refer you to other doctors and/or specialists in the network.
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Deductible
A flat amount of covered medical expenses that an insured
must incur before the insurer will make any benefit payments
under a medical expense policy.
Out of Pocket Max
A dollar amount set by the plan which puts a cap on the amount
of money the insured must pay out of his or her own pocket
for covered expenses over the course of a calendar year.
HSA (Health Savings Account:
An HSA is a high deductible medical
plan that includes a tax deferred savings account. The money
from the savings account can be used to:
- help meet the deductible
- help pay early hospitalization/medical expenses
- used towards personal retirement savings
HSAs are portable in much the same way that 401ks can be
rolled over when you leave your job.
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