What are Preferred Provider, Point of Service Plans and health maintenance organizations?

Preferred provider organizations (PPOs), health maintenance organizations (HMOs) and Point of Service (POS) are three forms of something known as managed care plans, which are plans designed to reduce health care costs. HMOs are both the insurance company and the health care provider. With some HMOs, insured individuals usually must use the HMO health care providers unless there is no suitable HMO specialist or other provider available within the HMO.

If that is the case, the individual will be referred to an approved provider outside the system. The primary advantage to the insured is that actual out-of-pocket expenses can be just a couple of dollars for each doctor's visit or prescription. The disadvantage is that it may not have any coverage for health care services performed by doctors or facilities that are not part of the HMO, which can be a major problem if you should be dissatisfied with the doctors or treatment plans offered through the HMO.

Preferred provider (PPO), and ...

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