Find the North Carolina Health Insurance Plans Right for You
North Carolina health insurance plans are available in many formats but most health insurance packages can be categorized into one of three main types. The categories are Health Maintenance Organization (HMO) plans, PPO (Preferred Provider Organization) programs and Indemnity plans, each with different requirements, benefits and restrictions. Each of these categories offers acceptable levels of health coverage for most individuals, but the plans differ in requirements, coverage, approved health providers and premiums.
With an HMO, only health services received from a network-affiliated health care provider will be reimbursed under the plan, and all specialized care must be referred by your primary physician in order to be a reimbursable service. With a PPO plan, health care is covered at a higher percentage when you use a network provider with negotiated network rates, but you may also use out-of-network providers and receive less reimbursement of your health care expenses. With an Indemnity insurance plan, you may use any health care provider you wish, and you should receive a set percentage reimbursement of your covered health care expenses. Out of these different programs, HMO plans will have the least expensive premiums, while Indemnity plans are very comprehensive and are based on the most expensive premium rates.
When selecting from an HMO, PPO or Indemnity plan, you should initially evaluate whether your preferred physicians, labs and hospitals participate in the HMO or PPO network. Next, you can determine how much freedom you might want in choosing specialists should you need specialized care. Finally, you will want to consider the trade-off between having more freedom in choosing doctors, labs and hospitals versus the significantly increasing premium prices associated with having more choices and flexibility.