Basic health insurance elements
PPO- A PPO plan is a health insurance plan designed for ease of use. The
insured has a broad list of providers that can be seen at any time and the
provider list includes both primary care doctors and specialists.
Co-pay- The co-pay is the amount that you pay for each doctors visit.
Deductible- Each year the amount of the deductible is the amount you pay
for your own medical benefits before the insurance pays for anything. This
applies mainly to hospitalization not doctor visits.
Stop Loss- Most policies have a stop loss which is the most you pay for any
single medical occurrence regardless of the final total cost.
HMO- An HMO has less freedom than a PPO since you must have prior
authorization from your primary physician in order to see a specialist,
however in many cases if you are in good health an HMO will often have a
much smaller out of pocket expense for the year
Office Visit- This is the amount that you would pay each time you see your
Specialist- The amount you pay to see a specialist after getting permission
from the company and your primary doctor.
Hospitalization- This is the amount you pay for hospital treatment.