Say this fast: HMO, PPO, PFFS, MSA, FFS.
If the acronyms make sense, you’ve done your health care homework, and you know they represent health care plans. If they’re not yet familiar to you, brace yourself. Whether you’re helping a family member find a health care plan, looking for one for yourself, or on Medicare and thinking of changing plans, you’re likely to encounter all these initials, and more.
The following summary may help you keep them straight.
HMO (Health Maintenance Organization). Your primary care physician provides routine care and makes referrals to network specialists.
PPO (Preferred Provider Organization). No primary care physician is required. You may choose any doctor or hospital, but you’ll pay more for services by non-network providers.
PFFS (Private Fee For Service). You can choose any doctor or hospital that accepts Medicare as long as the doctor or hospital also accepts the private plan’s terms and conditions.
MSA (Medical Savings Account). You may also know these as Health Savings Accounts (HSAs). The plan has a high deductible combined with a savings account that can be used for medical expenses. Medicare’s 2007 Handbook states they may be offered in 2007, but some states already offer them.
FFS (Fee For Service). The original Medicare plan allows you to use any doctor or hospital of your choice as long as they accept Medicare.
HMO, PPO and PFFS plans are also available for those under 65 and not on Medicare. Premiums, co-payments, deductibles and services vary with each insurance company.
To find the best plan for you or a loved one, go to seminars, call Medicare, check the Internet—and sort it all out before you put your own initials on the dotted line.