Skip to main content

View Diary: CoveredCA almost gave me a heart attack today (17 comments)

Comment Preferences

  •  Here ya go.... (9+ / 0-)

    An HMO -- short for Health Maintenance Organization -- starts with subscribers generally signing on with a primary care physician, who will act as a gatekeeper to other services and referrals. Services in an HMO are generally provided by a network of participating providers. Mercer Health officials said typically services received from non-participating providers are not covered by the plan.

    An EPO -- short for Exclusive Provider Organization -- is similar to an HMO in that it is a health care plan that covers eligible services from providers and facilities inside a network. Generally, an EPO does not pay for any services from out-of-network providers and facilities except in emergency or urgent care situations, which is similar to an HMO. People using an EPO generally are not required to have a primary care physician nor referrals, as HMO members are.

    A PPO -- short for Preferred Provider Organization -- is a health care plan that allows people to see doctors or get services that are not part of a network. Those out-of-network services are at a higher rate, though. Plans are structured so that members will pay less money out-of-pocket when they use in-network providers, Mercer Health said. In a PPO, members typically do not need to choose a primary care physician, said Paul Fronstin of the Employee Benefit Research Institute. He said they are also typically required to pay a deductible.

    if a habitat is flooded, the improvement for target fishes increases by an infinite percentage...because a habitat suitability index that is even a tiny fraction of 1 is still infinitely higher than zero, which is the suitability of dry land to fishes.

    by mrsgoo on Thu Dec 26, 2013 at 10:09:31 PM PST

    [ Parent ]

Subscribe or Donate to support Daily Kos.

Click here for the mobile view of the site