PPO-This is known as the preferred provider organizations. This health plan has both in and out of network providers. Referrals for specialists, preauthorization for some procedures, and some fees are discounted. This plan has a higher cost for out of network providers and coverage for preventative care varies. HMO- Is known as the health maintenance organization. You can only choose from the HMO network of providers, primary care doctor manages care, and a referral is required to go to a specialist. There is no payment for out of network non-emergency service. Pre authorization is always needed. The co-payments are low but, you are limited to only the provider network. An HMO does cover preventative care. POS- This plan is known as Point of Service Plans. With this plan you select a care physician from a list of participating providers. This is similar to how HMO’s are managed. All your medical needs are handled by your primary care physician. This is your point of service. The primary care physician will refer you to a specialist that is in the network physicians. There is
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Primary care physician, preferred provider organization, HMO, preferred provider organizations