Group Insurance Plans

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Group insurance plans are made available by companies employing more than fifty employees. The type of insurance can be a traditional third-party payer or it can be some type of managed care plan. It is vital that you read the insurance information provided by your employer and understand exactly what type of coverage you have with the company.

Some group insurance plans allow you to go to the physician of choice without the need for a referral from a primary care physician. This type of insurance may or may not be filed for you by the physician's office. You may be required to pay up front and get reimbursement from the insurance company.

Benefits Vary in Group Insurance Plans

Preferred provider organization plans are another type of group insurance plans. This is a plan that pays higher reimbursements for treatment by a PPO network physician or hospital that is contracted with the organization. PPO plans do not require you to have a primary care physician, but you do have to use a physician in the network for treatment.

Health maintenance organization (HMO) plans also require using a network provider to get the most benefit from the policy. One big difference in an HMO and a PPO is the HMO requires you to have a primary care physician and you can only see a specialist with a referral from him or her. That is one reason it is important to read the fine print in your employee health manual. If you do not go by the guidelines, you may be paying more for your office visits than necessary.


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