Ask Andy: O's of insurance - WMC Action News 5 - Memphis, Tennessee

Reported by Andy Wise

Ask Andy: O's of insurance

You got your HMO's, your PPO's, and you never really pay attention to them when your company's benefits coordinator hands you the paperwork.

If your company offers more than one of them, you really should try to make sense of all those "o's" in insurance. One may be cheaper, but it might not have the right coverage.

Here's a breakdown of the "o's" in insurance, with thanks to David Nganele, PhD, president of DMN Healthcare Solutions in New York and a contributor to Bottom Line Secrets, one of my consumer resources:  

HMO (HEALTH MAINTENANCE ORGANIZATION).  An HMO is best if you and your family are generally healthy -- no complicated health issues -- and you don't need specialists. HMO's are also your choice if you're OK with the doctors in their providers' lists and if you have children who need regular check-ups.

PPO (PREFERRED PROVIDER ORGANIZATION).  A PPO is your choice if you have to see a specialist for a specific medical condition. A PPO is also better if your doctor is out of network. Unlike an HMO, most PPO's cover out of network doctors, but at higher deductibles and co-pays.

POS (POINT OF SERVICE PLAN).  A POS is best if your family is healthy, but wants the flexibility of access to out of network doctors. With a POS, you can see any doctor you want, but you pay a percentage of your total bill. The policy typically dictates the percentage.

You might also consider a health savings account (HSA) if you're employer offers one. It combines high-deductible, low premium hospitalization coverage with a tax-free savings account for smaller medical issues.  You can contribute up to $2,700 per year as an individual or up to $5,450 for families (if you're between 55 and 65, you can toss in another $700).  Any unused funds can be carried over.  Ask your employer.

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