Point of Service plans are the latest type of plans to become popular. They combine the features of HMO and PPO plans. The cost of these plans are usually 10 to 20 percent greater than HMO. When electing this type of plan a person may be less apprehensive than joining an HMO, since they can access the PPO providers anytime. The features of these plans include a choose of primary care physician for the HMO benefits while having access to contracted POP and non network physicians. The HMO provides the least out lay for services while the deductibles and copayment percentages increase the outlay for those services when used under the plan.
Indemnity plans are becoming less popular because of there rising costs and not being able to maintain cost containment's associated with either PPO's or HMO's. They offer more flexibility with the ability to choose any provider of services. Plans offer a choice of deductibles, coinsurance, and stop losses. Benefits are paid to providers submitting claims on a reasonable and customary basis. Because providers charges have of claims in the form of increasing premiums to consumers.
These plans generally have been replaced by PPO plans which have retained some of the features of indemnity plans. Most companies today do not offer an indemnity plan except as an option to the POP plans with reduced benefits.
Todays dental plans like medical have evolved from indemnity plans to PPO's and Prepaid type plans. Prepaid plans offer less cost to the covered individual by a system of copayments for services. Usually services such as cleanings, exrays and exams are covered at 100%. Services for routine maintenance such as fillings, periodontics, endodontics, crowns, dentures have various copayments. These services depending on the plan will be covered under routine or major dental services. Each plan needs to be examined as to copayments, and category the services are in. Rates for prepaid will be directly reflected in the amount paid for copayments. The greater the copayments the less premium. Like HMO's you will have a panel of dentist to choose from, and be able to change providers periodically if needed. Benefits are not available for non network providers.
PPO plans are based on a deductible, and percentage for services where the plan has contracted for services at reduced rates. These reduced rates mean less out of pocket expenses for the covered person. As with medical you may use non network dentist with higher out of pocket out less since there is no savings from the provider contracts.
Indemnity plans usually are far more expensive than PPO or Prepaid plans and offer less coverage. There are vary few plans available for individuals and most will opt for prepaid because of the cost and better cover
Many companies today offer supplemental benefits at additional costs. Life insurance is one of those features offered as a term policy and benefits can be extended in some cases to the family. Some plans offer value added benefits such as vision referral at reduced rates with major vision care centers. Each plan will need to examined as to these benefits and there value, while keeping in mind the primary goal of providing quality medical care at affordable rates.
Additional types of plans are TEMPORARY PLANS which provide benefits for defined periods of time. They are useful for people between jobs with no coverage or as an alternate to cobra benefits. However it is important to note that people with preexisting conditions will be better served by cobra because of the pre- existing condition of these policies. Students and those traveling into the country or out of the country may find these policies or specialty policies designed for these specific people and ideal way of getting needed coverage. We will be happy to discuss specific situations and there solution with you.