| Characteristics |
Type
of Plan |
| Managed
Care |
Fee-for-service (FFS) / Indemnity |
Health
Maintenance Organization (HMO) |
Point
of Service (POS) |
Preferred
Provider Organization (PPO) |
| Does the plan have
a defined network of physicians and other
health care providers and facilities? | Yes |
Yes |
Yes |
No |
| Does the plan pay
anything towards the cost of seeing providers
outside of the plan's network? |
No | Yes,
but it will pay higher benefits for in-network
than out-of-network care. |
Yes,
but it will pay higher benefits
for in-network than out-of-network care. |
Pays same toward cost
of any provider you choose to see. |
| Does the plan require
that you have a primary care provider? |
Yes |
Generally yes,
to get the highest level of benefits. |
No |
No |
| Will you have to
have a referral to see a specialist? | Yes |
Generally yes,
to get the highest level of benefits. |
No |
No |
| Are you likely to
be responsible for filing claim forms? | No |
Not
for in-network care | Not
for in-network care |
Yes |
