Understanding Medical Insurance

In the event of an injury or medical emergency, it is important to understand the type of health insurance you have in order to help avoid high costs and preventable charges. Many employers offer several different plans, and therefore it is important to know the difference between them. HMOs and PPOs are two common types of plans you may run across and you should know the difference between the two.

A health maintenance organization, or HMO, is a group of healthcare providers that have a contract with your insurance company to provide services at a particular price. This means that HMOs are very restrictive as to which doctors you may see. You must choose a primary care provider who is within your network's coverage and must get a referral from that doctor to see any sort of specialist. Despite their restrictions, HMOs are advantageous because they usually cost much less than other types of insurance plans, with co-payments that are low or even free.

A preferred provider organization, or PPO, also has a contract with particular healthcare providers. However, PPOs are less restrictive than HMOs. With PPOs, you need not select a primary care provider and may visit any doctor you wish, and you need no referral to see a specialist. You may see a healthcare provider that is out of your network, but you must pay more. PPOs are generally more expensive than HMOs, but with a PPO you have more control over your own healthcare decisions.

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If you have been involved in a workplace accident, you may be entitled to receive workers’ compensation for your medical and financial losses. Contact the Charleston workers’ compensation lawyers of Steinberg Law Firm at 843-720-2800 to discuss your case and your legal options.