A California group health plan can be broken down into managed care plans, fee-for-service plans, health maintenance organizations (HMOs), point-of-service plans (POS), and preferred provider organizations (PPOs). It is important when looking at a California group health plan to figure out which type is best suited to your needs and the needs of your family.

Managed care plans are inherent in a variety of different kinds of healthcare plans. A California group health plan that is managed care plans a role in how often you will utilize healthcare services. In a managed care set up often you need to receive permission to go to the hospital from your insurance company and if you go and are admitted without their approval this could mean that they will refuse to cover the cost of your stay.

A fee-for-service plan is a conventional type of plan and one of the most common in the United States. In this case the insured person pays a premium when they seek out medical services and the insurance company pays out the rest. The insurer has the freedom to choose whichever doctor, clinic or hospital he or she wishes. The insurer must also pay a yearly fee known as a deductible and no health services will be covered until it is paid out. When it comes to a California group health plan the standard is usually $250.00 per individual per year and $500.00 for a family deductible once two members of the family have exceeded their individual deductible. It is important to bear in mind that not all of the health expenses you incur count towards your yearly deductible. It is only those expenses that are laid down in your policy. When in doubt, check it out.

Health maintenance organizations (HMOs) is a California group health plan that is prepaid for the insurer but the person then must follow the rules as laid out by the HMO. Patients cannot choose to see what doctors and specialists they wish to but must go to the ones that the HMO decides they will go to. This applies to hospitals as well.

Another type of California group health plan is the point-of-service plan (POS). A POS plan is basically a HMO type of plan, which is an indemnity kind of health plan, but there is some flexibility. With this kind of California group health plan patients are still covered for certain services if they choose to go outside of the POS for medical assistance.

Preferred provider organizations (PPOs) are a combination of an HMO and a conventional fee-for-service plan. With this type of California group health plan you are limited by the HMO side of things as to doctors and hospitals but if it is necessary you can go outside the PPO for medical help and still be covered for service. You must show your insurance card at doctor’s visits and sometimes a co-payment is necessary. PPOs generally cover forms of preventative medical care.

Learn more at: www.baahealth.com