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You’ve probably heard the terms HMO, PPO, and EPO. We created a simple side-by-side chart that shows the basic features of HMOs, PPOs and EPOs. Please note, there is no right or wrong choice when it comes to selecting your health care plan, it’s more of a preference, not a wrong or right choice. Do you prefer to eat an apple or banana? It’s a preference. Having a clear understanding of these plans and how they work will help you in choosing the plan that’s best for you, your family, and your budget.
PPO stands for Preferred Provider Organization. A PPO health insurance plan allows for more flexibility and more choices when it comes to your healthcare. It offers a network of healthcare providers to choose from and you have the freedom to receive care from within that network or choose an out-of-network doctor, specialist, or hospital, without a referral. Keep in mind, however, that your out-of-pocket medical costs are lower when you choose an in-network provider but overall, out-of-pocket costs are higher with PPO Plans.
PPO plans do not require you to choose a Primary Care Physician (PCP) and do not require referrals. Let’s say you have a doctor or specialist that you like and have been seeing for years. With a PPO plan you could continue your visits whether they are in-network or out-of-network and without the need for a referral. If your PPO plan has a nationwide network of doctors, you can go anywhere in the USA. Check your plan details for more info.
It is important to remember that while you can receive care from any doctor, specialist, or hospital you choose, you will save more money by choosing an in-network provider.
The greater flexibility of a PPO often comes with a higher monthly premium, co-pays, and other costs too. While you can choose to use doctors, specialists, or hospitals outside of your network, finding health plans that are PPO in Nevada have been in short supply since the passage of the ACA. Please call us for the latest on availability of PPO Plans in Nevada. We have several EPO plans now available that work like PPO Plans.
HMO stands for Health Maintenance Organization. With an HMO plan, you must choose a Primary Care Physician (PCP) from a network of local healthcare providers who will refer you to in-network specialists or hospitals when necessary. All your care is coordinated through that PCP. HMO plans won’t cover out-of-network care except in an emergency.
With an HMO plan, your out-of-pocket medical costs and monthly premiums will generally be lower than a PPO.
With an HMO plan, you’ll select a Primary Care Physician who will be your contact for all your healthcare, and they will connect you to specialists or other health care providers.
Knowing how to react when they appear can greatly reduce your chances of being involved in an accident. While hitting an animal can be against your natural instincts, swerving to avoid it could cause a worse crash that ends up in major fatalities.
Nevada Health Link has responded to Governor Sisolak’s Emergency Declaration of March 12, 2020 due to the coronavirus, also known as COVID-19. It announced an Exceptional Circumstance Special Enrollment Period. This allows Nevada residents who missed the “Open Enrollment” period to enroll in a qualified health insurance plan through the state-based exchange platform.
The Department of Health and Human Services announced that there will be two new rules created to help improve competitive pricing between hospitals, health insurance issuers, and health plans. The effort is aimed at helping to empower patients when they make their health insurance decisions.
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EPO stands for “Exclusive Provider Organization.” An EPO is a type of health insurance plan that offers a local network of doctors, specialists, and hospitals in your area for you to choose from. These plans are among the most affordable options with generally low monthly rates and many of the plans contain co-pays before the deductible.
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It’s important to note that those with an EPO plan have health insurance coverage only for in-network doctors and hospitals, and there are no out-of-network benefits (except for emergencies). For that reason, an EPO health insurance plan may be well-suited for those whose doctor is either part of their plan’s network or for those who don’t mind switching to another doctor. It may also be for those who enjoy the idea of not having to get a referral to see a specialist. Keep in mind, however, you’d have to stay within the EPO’s network.
If you’re considering an EPO plan, it’s important that you carefully read the coverage terms and fine print of the plan. EPO health insurance plans are an attractive option for many because they have relatively lower monthly premiums.
In general, EPO plans may be a good option for those who want the freedom to schedule appointments directly with specialists and don’t mind the possibility of switching to a healthcare provider that is covered by their network. If the specialist requires you to get a referral, that is the doctors preference, not a requirement of your insurance plan. Look for plans that have more “1st dollar benefits” meaning, co-pays BEFORE the deductible. Not all plans are built the same. Some EPO plans will have a higher deductible but give you lower co-pays. Some will have lower deductibles and give you higher co-pays.
Some EPO plans may have HSA (Health Savings Account) plans, which are health insurance plans where you can open a separate bank account and place money into this account using pre-tax dollars to pay your medical expenses with. These plans, however, generally do not have any co-pays until the deductible has been met, but do offer tax savings if used correctly.
Unfortunately, insurance company’s use a variety of coverage terms that are often riddled with industry verbiage that can be difficult to decipher. At Nevada Insurance Enrollment, our health insurance agents specialize in helping our members understand their options. To learn more about HMO, PPO, or EPO plans or to apply for health insurance, contact one of our licensed agents today
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Med Pay is a great benefit to be added to your auto insurance policy. Med Pay is usually available in lower sums, like $1000, $5000, etc., regardless of who’s at fault in an accident. Med Pay can be used to pay for some of you and your passengers’ health insurance related costs.
Most insurers offer a variety of discounts that can help you save money on your monthly insurance premium. Most drivers know that if they insure two cars under one auto insurance policy, they’ll pay less on that one policy than they would on two separate policies.
Determining if you can use a personal auto insurance policy or that you should get a commercial auto insurance policy can be tricky. Sometimes you can buy a personal auto policy for business use and can be enough for some businesses. But if you are required to cover high liability coverage, have an unusual vehicle to insure, haul equipment, are a taxi or rideshare driver, you are probably going to need commercial auto insurance or special endorsements and coverages.
The Division of Insurance (DOI) stated that Nevada’s insurance carriers have decided to only offer coverage to Clark, Washoe, and Nye counties beginning in 2018. Nevada’s Exchange actively exploring potential solutions and resources for consumers facing limited to no coverage options.