Health Insurance

Health Maintenance Organization:

Health Maintenance Organizations offer comprehensive medical coverage through an exclusive network of providers, either owned or contracted. When applying for HMO coverage you select a Primary Care Physician - PCP who will be your primary source of medical attention. When needed, your PCP will refer you to specialists within the HMO network. For all routine care you must use your PCP, however exceptions are made for emergencies.. Your out of pocket expenses are limited at the time you visit your doctor, hospital or other provider, or when you buy prescription drugs. No claim forms are needed.

Can you see a specialist without a referral?

Blue Shield of California offers a plan called Access Plus which allows you to see any specialist within your medical group, at any time without a referral. Slightly higher co-pays apply when you go directly to a specialist.

PPO:

Preferred Provider Organization is a plan which uses a network of doctors with whom the insurance company has negotiated discounts for it's members. In a PPO plan you are free to select any network provider or specialist without a referral. You may also see providers/specialists, who are not contracted with your insurance carrier, however you will be responsible for a larger portion of the bill. You will pay the first $250 to $5,000 in services you receive each calendar year, as a deductible. Still most PPO plans waive the deductible for basic services such as office visits and prescriptions. Flat co-pay is charged for these services. Also, some PPO plans have no deductible at all.

For further details, Please visit www.allconnection.com.

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