Employers are constantly searching for ways to bring down the cost for group health insurance premiums. While the answer used to be “switch to an H.M.O”, this is no longer the case. While H.M.O. plans used to offer much lower premiums because patients were limited in where they could go for care, the rates for such plans have increased at such a steady pace, many of them have surpassed the PPO options in terms of monthly rates. The average increase for an H.M.O. in 2011 was 9.8%, the highest increase in five years.
Posts Tagged ‘HMO plan’
California Sees Rise in HMO Premiums
Friday, March 4th, 2011New Rules on Medical Wait Times
Friday, February 25th, 2011Starting this month, new protocols were implemented to regulate waiting times for California residents. These guidelines were primarily designed for HMO patients, but do extend to PPO’s as well. As it seems that more time is spent in the waiting room rather than with the doctor, these wait times provide some much needed relief. For the first year, the California Department of Managed Care will oversee that the rules are strictly followed, and health plans that fail to meet the wait times will find that they face possible fines and penalties. As it will be the insurer’s responsibility to meet the guidelines, it will also force the expansion of their provider networks to meet the need for timely care. The rules note the following maximum wait times:
California's Timely Access to Medical Care
Sunday, February 14th, 2010Recently, the California Department of Managed Care has released some new guidelines for HMO patients, in order to create a more efficient and comprehensive level of care for these patients. Among the new rules:
• A physician appointment within 10 business days of a request
• A specialist appointment within 15 business days of a request
• An urgent care visit within 48 hours of a request
• Telephone access to a health care professional at all times.
Understanding Insurance Terms
Friday, June 5th, 2009We all know how confusing insurance terminology can be. Here is a short list of the most commonly used terms to help you better understand the fine print on your policy:
HMO: refers to Health Maintenance Organization. HMO’s provides comprehensive health care by network physicians to those in a particular geographic area. With an HMO, you need to access care through a designated Primary Care Physician.
PPO: Preferred Provider Organization. PPO plan members receive full coverage by using doctors and hospitals within the PPO network, or they can pay more to go outside of the network for care.
