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Traditional Major Medical, HMO, PPO. Which one is your plan? Know the difference?
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How do Traditional Major Medical, HMO, and PPO plans differ?

A traditional Major Medical plan refers to an insurance policy that allows you to be reimbursed for covered medical expenses after certain conditions are met. One of the conditions is that you pay a deductible. As a general rule, the higher the deductible, the lower the premium cost. The advantage of Traditional Major Medical plan is that you will be able to choose your doctor without reference to an approved list provided by the insurance carrier.

An HMO (Health Maintenance Organization) is a managed care program. You will be required to select a Primary Care Physician from an approved list provided by the HMO. This physician will then direct all of your medical treatment including referring you to a specialist. If you fail to see your Primary Care Physician first (unless in an emergency situation), your benefit will either be sharply reduced or totally abolished. Normally, a HMO plan provides comprehensive medical care, such as immunizations, and physical exams. The filing of claim forms may also be omitted since your Primary Care Physician can claim the expenses directly from the carrier.

A PPO plan (Preferred Provider Organization) combines elements of a Major Medical plan with an HMO. You can either visit a doctor within the preferred list or choose an out-of-network doctor or hospital. However, an increase percentage of the cost will be charged to you if you don't use the participating doctors.

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Know the difference!
What is the difference between Traditional Major Medical, HMO, and PPO? Click here.

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