Michigan Health Insurance and Managed Care Plans

If you are buying Michigan health insurance you need to consider the managed care plans that are available. Generally speaking, managed care plans fall into three categories: HMO, POS, and PPO

A common trait among all the plans above is the incentive that entices the insured party to see providers within a certain network. Not only is this good for the health insurance provider, but it allows for the insured to get more affordable coverage as well.

Health Maintenance Organizations - HMOs

HMOs provide treatment to the insured on a prepaid basis. This means that members pay a fixed monthly rate, regardless of how much care is needed during that time. In return, most HMOs provide a number of common medical services including office visits, surgery, and much more.

Preferred Provider Organizations - PPOs

A PPO consists of hospitals or doctors that only provide services to a certain group. Rather than prepaying like an HMO, PPO members pay for medical services as they incur them. The PPO sponsor, such as an employer, usually reimburses members for costs minus any co payment. In many cases, doctors will also submit the bill for service directly to the insurance company as well. The health insurance company will then pay the covered amount.

Point of Service Plan - POS

In this plan members do not pay deductibles, and only pay a small co payment when dealing with in network providers. Additionally, members must choose a primary care physician (PCP) who is responsible for providing in network referrals as they see fit. With a point of service plan, getting coverage out of network will mean that you have to pay a deductible, and that your co payment will be based on the doctor's charges.

As you can see, when buying Michigan health insurance you need to consider all of your options. There are many to choose from.