Most of us think that insurance coverage is confusing enough, well throwing in some more abbreviations does not make it any clearer. These abbreviations have been around for a while, yet many of us really have no idea what they stand for, what they entail, and which ones they currently are a part of. Open enrollment will be here before we know it, so here is a brief breakdown on what these abbreviations actually mean:
HMO
Stands for Health Maintenance Organization.
If you belong to an HMO, then you are limited to receiving care from providers in that specific network. HMO’s also put an emphasis on primary care, making the primary care provider a form of gate-keeper, requiring referrals.
PPO
Stands for Preferred Provider Organization.
If you belong to a PPO plan then you have the option to receive care from providers that are outside of the “preferred network,” but likely will have a higher deductible. Also, referrals are typically not needed.
FSA (flexible spending accounts) and HSA (health savings accounts) are consumer-driven plans that allow you to have more control over how you spend your money on health care.
PCMH
Stands for Patient-Centered Medical Home.
A practice must meet certain standards to become a patient-centered medical home. This often involves bundled payments, where a fixed amount is paid per month. One goal of PCMH is to promote more efficient care.
ACO
Stands for Accountable Care Organization.
This is an organization that includes, not only a primary care practice but hospital and specialty care as well. The goal is to improve coordination by working together to provide high-quality care.
So, which plans should you have, or do you have? Well, it depends on several factors such as your age, current health, living situation, and much more.
We can help clarify it all. Contact us today. [email protected]