Family or individual health insurance can provide the important protection needed in the
event of illness and for regular preventive insurance care. Health insurance plans that
allow you the most choices in doctors and hospitals also tend to cost more than plans that
limit choices. Family and individual health insurance plans that help to manage the care
you receive, such as PPO and POS plans, usually cost you less, but you must give up
some freedom of choice.
Learn more about HMO, PPO, and POS managed health care
insurance plans below or click on the link for additional information
on Major Medical health insurance.
Subscribers to an HMO receive medical services from participating
physicians, clinics and hospitals. You choose a primary care physician
(PCP) from a list of participating doctors. That doctor is used for
typical circumstances such as annual exams and usual health issues.
If you need to see a specialist, be hospitalized, or have lab or X-ray
work, your doctor will refer you to a provider or facility within the
HMO system. Your doctor must give authorization for those services
to be covered by your HMO. In other words, you must see HMO
approved physicians and use HMO approved facilities or pay the
entire cost of the visit yourself.

Like Point-of Service (POS) and PPO's, HMO's have made
arrangements for lower fees with a network of health care providers
and give their policyholders a financial incentive to stay within that
network.

You may have to pay some portion of the cost (co-payment) for each
office or hospital visit, such as $20 - $30 per doctor visit, regardless of
what the services cost. Also, some services such as emergency room,
mental health and chemical dependency services, may carry additional
costs in an HMO health maintenance plan.
You can see any health care professional in the network any time you
choose to make an appointment. You don't need referrals for specialists
or other services as you do in an HMO. You can see doctors or
specialists outside your PPO network, however, your portion of the costs
will be higher.

Less restrictive than an HMO or PPO, a (POS) or Point of Service plan
lets you see any licensed health care professional for anything covered by
the insurance. Care you receive from out-of-plan health care
professionals is reimbursed, but you must pay an often times much higher
co-payment or deductible amount. While you may choose to see a
physician outside the network, if you don't receive permission from your
(PCP) primary care physician, you're likely to end up submitting the bills
yourself and receiving only a small reimbursement - if any.

Costs that exceed your deductible are covered by a co-insurance plan in
which you and the insurance company share the cost for services covered
by the policy.

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Guilford, CT 06437
203-453-0392
Toll Free: 1-888-467-3330
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Individual / Family Health Insurance Services
Click on the link below to fill out a quote form for a
health insurance policy that will provide exceptional
insurance protection for you and your family at an
affordable cost.
HMO Health Insurance Plan Features

HMO Health Insurance Plan Overview

* Must get a referral from your PCP to visit
a specialist
* Fixed monthly fee
* Preventive care emphasis
* Primary care physician (PCP) coordinates your
total care
PPO Health Insurance Plan Features (Family or Individual)
PPO Health Insurance Plan Overview (Family or Individual)
* Convenient access to quality health care
* Large and diverse network available of primary care physicians,
specialists, hospitals & clinics.
You may have to pay some portion of the cost (co-payment) for each
office or hospital visit, such as $20 - $30 per doctor visit, regardless of
what the services cost. Also, some services such as emergency room,
mental health and chemical dependency services, may carry additional
costs in a PPO health insurance plan.
* Pay for services as they are provided
POS Health Insurance Plan Features (Family or Individual)
POS Health Insurance Plan Overview (Family or Individual)

* Preventive care emphasis
* Pays benefits for out-of-network care, but at a lower level
Also, some services such as emergency room, mental health and
chemical dependency services, may carry additional costs in a POS
health insurance plan.
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