Types of Health Plans: The Road Map

So you're ready to cruise towards your medical plan options.

But now that you're sitting at the intersection,

you see all these different types of health plans.

How do you decide which way to turn?

Let's take a look down each road with Ted and explore the options more closely.

On the right is PPO Highway.

If you turn this direction, you can see any in-network provider at any time

without a referral.

You can even take an off-ramp to an out-of-network doctor,

but you'll pay a hefty toll.

On PPO Highway, you choose your own route, but you generally pay more for that freedom

in both premiums and services.

To the left is HMO Boulevard.

With access to this gated community,

you choose one primary care physician and "park" while they coordinate all your care.

If you need to see a specialist, your PCP will refer you to a provider in

their exclusive HMO network.

There are no off-ramps here.

So if you leave the neighborhood to see an

out-of-network doctor, it won't be covered and you'll pay the costs in full.

But as long as you let your primary doctor map your route,

you'll typically pay less for high-quality coverage and services.

And there's still another road.

Straight ahead on Coordinated Care Model Avenue

you need to "park" at a Medical Home, where a primary doctor will coordinate your care

and refer you to other providers as needed.

You may also have access to those out-of-network off-ramps (and their hefty tolls)

if you feel the need to take a road trip.

So what is a Medical Home, and why do you need to park there?

Think of your Medical Home as the building where your primary doctor lives.

It could be a big multiplex with lots of providers,

or it could be a tiny house where only your PCP lives.

The key is the primary doctor in your Medical Home has close relationships

with their CCM family and friends.

Those other CCM providers may live in the same house, or next door, or further

down the Avenue, but they all talk to each other often.

So everyone involved in your care knows the latest news.

By "parking" and letting your PCP guide your healthcare journey,

the whole CCM community can work together to get you

the right care at the right time.

When choosing your health plan, consider your personal needs and preferences.

If you're someone who likes to take the wheel and explore the open road without

many restrictions, a PPO might be best for you.

If there's an HMO or CCM option in your area, you could save some money,

and some stress, by etting your PCP map your route and coordinate your care.

No matter which way you turn,

OEBB ensures all your health plan options provide safe, effective care.

So choose the path that's best for your medical needs, and your pocketbook

and you, and Ted, will be on the fast track to good health!