Health Insurance - Top Ten Questions

Standardized Direct Pay

  1. What are the benefit packages are available?
  2. What is the difference between an HMO and other health insurers?
  3. What is the difference between the standardized HMO product and a point of service plan (POS)?
  4. Do I need a referral to see an out of Network Doctor if I have a Standardized HMO product?  What If I have a POS product?
  5. How can I tell if my Doctor is participating doctor with a health plan?
  6. Are there any deductibles, coinsurance amounts or lifetime maximums which apply to my coverage?
  7. What are the premium rates for the standardized product and POS product for the different plans operating in my geographic area?
  8. Will there be a  pre-existing condition limitations that may apply, and if so, how does it apply?
  9. When will my premium rates change and how much advance notice of the increase will I be given?
  10. I have often heard the term "usual and customary" fees.  What is this, and how does it affect me?