The Complex World of Health & Dental Insurance

Health Insurance in the U.S. is pretty complex for a layman. There are predominantly three categories of insurance - HMO, PPO and EPO.

 HMO

Health Maintenance Organization (HMO's) are prepaid health plans, As an HMO member you pay a monthly premium. In exchange, the HMO provides comprehensive care for you and your family, including doctors' visits, hospital stays, emergency care, lab tests, x-rays and therapy. The HMO arranges for this care either directly in its own network of doctors and other health care professionals under contract. Usually, your choices of doctors and hospitals are limited to those that have agreements with the HMO to provide care.  

There may be a small co-payment for a doctor's visit or for hospital emergency room treatments. Your medical cost will likely be lower and more predictable in an HMO than with high-end PPO. With this type you may need to get a pre-approval to go to a specialist, for lab work etc. from your primary care physician.

PPO

With the Preferred Provider Organization (PPO's), you can go to any doctor (preferably within the network), you present your card and do not have to fill out an form. Usually there is a co- payment for each visit. For some services, you may have to pay a both deductible and coinsurance. In a PPO, you can use doctors who are outside the network to still receive some coverage.

At these times you will pay a larger portion of the bill yourself (and also fill out the claims forms). Some people like this option because even if their doctor is not a part of the network, it means you can still go to the doctor of your choice and get the treatment.

EPO

This is an Exclusive Provider Organization. It is a blend or a hybrid between HMO and PPO. 

Unlike HMO, one needn't have to go through the gatekeeper (primary care physician) however, they must be seen within a specified network. One cannot go to Out-of-Network care providers.

DENTAL

Dental Care in the U.S. is expensive. Therefore getting Dental Insurance helps provides 'Peace of Mind' when you need it. 

Delta Dental is one of the leading provider of dental Insurance in the nation. Get your Free, No-Obligation Quote here:

https://www.deltadentalins.com/shopping/delta/get-a-quote?issuerCode=DELTA&brokerId=214606