There are 3 main types of policies for individuals, children, families and the self-employed: PPOs, HMOs and Traditional Plans. The following is a brief review of each type:

PPO Plans
The PPO (Preferred Provider Organization) is a plan where you have a large choice of providers within a network. You can choose any provider in the network and can change providers whenever you like. You choose your deductible which can be $250, $500, $1000, $2500 or more.

In a calendar year after you pay your deductible the insurance company will start paying a certain percentage of the covered medical expenses. This is called the co-insurance. For instance they'll pay 80% and you'll pay 20% until you reach the stop-loss amount, after which they will pay 100% of the covered medical expenses.

Plans vary according to the benefits they offer. Some plans offer special options; Doctor's office visit co-pays, Maternity coverage, emergency room coverage, critical illness extra benefits, life insurance.

HMO Plans
The HMO (Health Maintenance Organization) is a plan where you choose one doctor who is your primary care physician. You must first get permission from your primary care doctor if you need to go to a specialist. That is why they are sometimes called Gatekeepers.

You do not have freedom of choice. You pay a monthly premium, and most of your services will cost very little. Although they are still available, many HMOs have gone out of business in the last few years.

Traditional Plans
Traditional or Indemnity Plans are not as available as they were 10 or 15 years ago. This is the plan where you choose any doctor or any hospital for your services. You will still have a deductible, a co-insurance amount and a stop-loss, just like with the PPO plans. The difference is that here you have complete freedom of choice. These are the most expensive plans.

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