Wellness benefits are the range of services that are added to health insurance coverage at little to no inclusive cost.
With the change in lifestyle and pattern accustomed by various individuals, having health insurance helps you manage your health by offering some wellness coverage like gym, yoga centers, dieting and how to control your body weight including the other basic things provided by insurance company like health care facilities, bills, diagnostic centers, and regular checkups.
Here are four types of insurance plans with wellness coverage to help you live a better and healthy lifestyle.
1. Health Maintenance Organisation (HMOs):
Health Maintenance Organisation with regards to their policy with a monthly or annual fee by members provides coverage through a group of physicians. HMO is one of the most popular health insurance plans because physicians provide members with their services including specialist visits, types of preventive care and when the specialist visit is made, the primary care provider makes a referral. Further, Health Maintenance Organisation offers lower monthly premiums, deductibles, co-pays, and coinsurance. Having a HMO plan, there is no specified number of times to visit and usually the cost of drugs are low or require a small co-payment.
2. Point Of Service (POS):
Point of service insurance policy incorporates both HMO and PPO. With a POS insurance plan, you can choose a primary care physician within the plan’s network or outside the local network where you’ll have to pay the cost yourself as it’ll be higher. The point of service insurance’s biggest advantage is how favourable and flexible it is to different individual budgets.
3. Preferred Provider Organisation (PPO):
The PPO is a medical insurance care where professionals provide health services to clients at a reduced rate. Unlike HMO, Preferred Provider Organisation offers a wide range of providers at a higher cost because they are more expensive to manage. As a result of their more comprehensive coverage, they offer services that some insurance plans might exclude and might charge an additional premium for wellness coverage. They do not allow individuals or families to choose their primary care physician and copayments are given for non-preventive medical care and annual deductible.
4. Exclusive Provider Organisation (EPO):
Exclusive Provider Organisation provides to members whenever required except emergency cases. Just like the HMO, individuals have a primary care physician that will provide in-network specialists. With an EPO, you don’t need referral in order to have your insurance covered. Also, a pre-authorisation will be needed if you’ll be visiting an out-of-network provider and if you intend on seeing a specialist within your network, a primary care provider referral is not needed.
The types of wellness coverage offered to members differ and this depends on the type of insurance policy. It is necessary to understand the terms and conditions to avoid misinterpretation.