Posted on May 15th, 2008 in Business Health Insurance

Pet is dear to all. Once a person brings a pet home, it becomes an important member of his family. He or she takes care of it like any other family member. People usually prefer to have a cat at home. Cat is a very sweet creature and a person feels happy enjoying time with it. He enjoys its jumping and various other activities. After a long tiring day at work, when a person returns home, he feels relaxed on spending some time with his pet. Cats are very sensitive and they require extra care. Without your notice, your pet may meet with an accident or may eat some rotten food. In this case, it requires immediate treatment. Sometimes, a person may not be able to bear the expenses of the treatment and hence, he opts for the cat health insurance.

Cat health insurance provides reimbursement coverage for your pet’s eligible medical treatments, surgeries, lab fees, X-rays, prescriptions and more. Whenever, your pet suffers from any sort of diseases, it is always wise to consult a veterinary doctor. It is beyond the capacity of the owner to understand the problem of his pet and to suggest any medicine. Before the disease of your pet becomes chronic, you should immediately take it to a good veterinary doctor. Proper care can only help your pet to get rid-off its problem quickly. Many a times, your pet incurs various diseases and sometime the cost of treatment of those problems may be very high. And, if you are not in a position to bear the expenses of the treatment then cat health insurance will be a great help.

With cat health insurance, all your worries of providing a good medical treatment to your pet will be solved. You will feel tension-free and would not panic on your pet’s treatment. With this insurance, you can undertake any sort of treatments. Your pet entertains you and at the same time provides you loyalty, love and companionship. So, it is your key responsibility to provide it with the best treatment at the time of necessity. You feel really annoyed and guilty if you are unable to bear the expenses of the treatment of your beloved pet. One always wants their pet to be in a good health and eat and drink properly.

There are many insurance agencies that provide cat health insurance. You can get the information of those agencies on the internet. You can also apply for the insurance policy online. Before applying for one, you should understand all its policies. An insurance agency understands the needs of his client and provides various treatment facilities to the pet owners. Pet insurance helps you cover the rising costs of veterinary care, so you need not have to choose between your pet’s well-being and your finances. Whenever, his or her cat suffers from any pain, the owner can understand its pain by its facial expression and gets it treated from a good veterinary doctor. The treatment of some diseases of a cat may be very expensive and a cat health insurance can help the owner in this case.

Robert Scott is a veterinary doctor and through ages having been dealing in pet insurance. If you want to know more about pet insurance,Pet insurance Online, Cat health insurance, Veterinary pet insurance. you can visit http://www.insuranceforpets.net

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Posted on May 15th, 2008 in Business Health Insurance

Owning a dog is a lot of fun and brings us many positive feelings and memories. People are sometimes blinded by all the good that comes from owning a dog that they tend to forget the fact that dogs are expensive. Especially if your dog has a medical issue that requires frequent veterinarian trips, medication or corrective surgeries and procedures. This is why dog health insurance plans have become increasingly popular. Let’s face it; your dog is practically a member of the family and now they can be treated just like any family member under your regular health insurance.

With this insurance your dog will get the best available care without breaking your bank account. It’s no secret that veterinarian fees and dog medical costs are on the rise. This is why a reliable plan is a tremendous way to reduce insane out of pocket expenses. Some dog owners have been known to set money aside in case their dog experiences a medical emergency. There is no longer any need for this with dog health insurance. Your dog can receive the proper medical attention regardless of your financial situation.

It is presented like any other health plan. It comes with premiums, exemptions and a wide selection of coverage plans. Some insurance will exclude dogs with pre-existing conditions while others will cover the same dogs. Some plans are based on the size of your dog or the dog breed. Coverage on these plans will typically start whenever the dog is six to eight weeks old.

You can find a health insurance plan through a simple online search or by asking neighborhood veterinarians, dog groomers, pet store owners or shelters. From there it’s just a matter of contacting the insurance carriers and asking for free price quotes. It’s important to get detailed information about each plan’s coverages, deductibles, exclusions and maximum payouts. Do plenty of research on the web and request brochures or pamphlets.

Finding the right plan is something that must be taken seriously. You want your dog covered regardless of illness or incident. Insurance has become so necessary in recent years that many companies are even offering their employees a pet insurance plan in their benefits package. Don’t let you and your dog go without one. An insurance plan just may prolong the lifespan of your dog and save you some financial woes.

Scott Jackson has been in the Pet Industry for over ten years. He has managed large Pet Specialty Retail stores and has worked as a distributor rep in the pet industry. He is a pet owner and lover who has extensive knowledge in pet nutrition and care. He runs a website http://www.coloradopetresources.com and http://www.dogandcatarticles.com where he gives information on pet care, location of Colorado independent pet retailers, vets, breeders and a general meeting place for pet lovers.

Visit http://www.coloradopetresources.com and find the information you need.

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Posted on May 15th, 2008 in Business Health Insurance

How many times have you heard a pet owner wish he had bought pet health insurance?

Statistics show that people are willing to foot the growing medical bills for their beloved pets, making the need for pet health insurance a real concern. Advances in pet health care can leave owners with big veterinary bills. Pet health care insurance is now affordable and available for dogs, cats and exotics.

If you would not think of being without insurance for yourself and your family, that should include your pet companion as well. Pet insurance is not as expensive as human insurance and might come in handy.

Pet health care insurance is similar to human health insurance. Like all insurance, you hope you never use it. Pet health care insurance will pay or reimburse for veterinary services that are covered under the plan. Medical treatments and technologies used for humans are now being used for pets.

If your pet needs an emergency surgery it would be nice to know that cost is not a factor and you won’t have to pay for everything on your own. The insurance is just sensible.

Purchase insurance coverage ideally when your pet is still young before pre-existing conditions develop. You can enroll as young as 8 weeks. Some plans only allow enrollment up to age 10 for cats and age 8 for dogs (age 6 for some breeds). Once enrolled, your pet may stay in the plan for the rest of its life.

Because of their natural adventurousness and high activity level, very young pets are famous for getting hurt and needing emergency care.

There are many pet insurance companies to choose from, and many different plans available. Read the fine print. Some companies have veterinarians that belong to their network. Under those particular policies, you pay a co-payment up front and the insurance company pays for the covered services. The downside is you have to find a veterinarian that is in the pet health care insurance “network”. Each policy is different and there is no one plan that fits everyone’s needs.

Services covered under many policies include spay surgery, neuter surgery, annual vaccinations, flea preventative, annual heartworm preventative, heartworm test, annual dental cleanings, accidents, illnesses, cancer, x-rays, and surgeries. In many cases, pet health care insurance will cover even more in maintaining the wellness of your loved pet. Your coverage may also include prescription foods, boarding, euthanasia, accidental death, recovery of lost pets, and micro-chip identification. Pet health insurance can prove to be invaluable.

Additional facts to consider when enrolling.

Are pre-existing conditions covered, and what constitutes a pre-existing condition? If a pre-existing condition is covered, what are the deductibles? Does the pet health insurance policy you are interested in cover prescription costs? Will my premium go up over time, as I file claims, or my pet gets older? Does the plan cover chronic or recurring conditions? What are the financial limits of coverage? How are they applied? Do you have more than one pet that could benefit from insurance coverage and are there multi-pet discounts available? Does your particular policy require monthly or annual payments? Talk to your veterinarian about your pet’s health and question the insurance companies about the limits of the pet health insurance coverage before purchasing a particular plan.

The right insurance plan requires some homework. We’ve brought you the best.

We have existed as a company since 1985, but it was a love of dogs, the dogs that have been a part of our life, and the passing of one dog in particular, Rusty, that inspired the creation of http://www.callofthedog.com and http://www.callofthedogshop.com — created to provide the things your dogs and pets need.

The two sites are dedicated to the dogs we have loved so deeply, and who have given us so much love in return. Purebreds and mixed breeds, but mostly rescues in need of a home. We educated them, but each one has had something to teach us in exchange.

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Posted on May 15th, 2008 in Business Health Insurance

There are many issues to consider when purchasing health insurance for your cat or kitten. Purchasing health insurance for your pet can help you afford a procedure that would otherwise be prohibitively expensive. Accidents or disease are events that we can’t anticipate or foresee, but we can safeguard against them - if we choose the right plan.

Many variables need to be considered in choosing the right pet health insurance plan, including your financial circumstances, the environment in which you live, whether or not you have other pets, and what veterinary service you do business with.

First, if you already have a vet with whom you have a trusting relationship, you need to find out what pet health insurance companies they accept. Most vets limit the number of insurance companies they work with, as doing so makes it easier for them to recommend a treatment course of action that they know will be a covered expense.

Another point to consider stems from the fact that depending on the procedure that is recommended for your pet, a referral to another specialist, animal hospital, or veterinary school may be necessary. In this case, you want to be sure that the services of the referred specialist are also covered by your plan.

Naturally, you also need to weigh the various insurance options available to you. There are various levels of coverage available, with some being far more comprehensive (and somewhat more expensive) than others. Make sure that you fully understand what is covered under your plan. While surgical procedures following an accident may be covered, for example, other conditions may not - such as pre-existing conditions or disease that may be related to a hereditary condition.

In choosing your plan, you will be given a choice of the level of deductible. This is the amount of money that you will have to pay before the insurance kicks in. Generally speaking, the higher the amount of the deductible, the lower your monthly premium will be. Sometimes the deductible may be per-incident, or in other cases, there may be a yearly deductible. One plan may offer 90% coverage with a 10% deductible, for instance. Since it’s impossible to know which option would ultimately be the least expensive, most people choose an option that represents a compromise: a monthly premium that can fit into their budget, and a deductible that will be affordable if the situation arises.

Prescription medicines are usually not covered as a matter of course, though some companies may offer this as an option for an additional fee. Chronic conditions such as feline diabetes require medications that can be quite expensive, so this may be an option worth considering. Bear in mind that this coverage may only include the cost of the medication alone, and not the cost of the corresponding office visit to your vet.

More comprehensive pet insurance plans may include coverage for certain preventative procedures. This ‘wellness treatment’ may include certain procedures such as vaccination shots, or neutering and spaying. The costs of these treatments are fairly predictable, and so this coverage may not save you money in the long run, but it would allow you to amortize the costs of these procedures over time, making budgeting for them a little easier.

Ultimately, we can never be certain about which course of action will be the least costly to us. Taking out insurance is really no more than placing a bet - but it’s a bet that we hope to lose. We don’t want to have accident or a fire so that we can take advantage of our auto or home insurance policies. Similarly, we may choose health insurance for our pet, but we want our pets to remain healthy. At the very least, pet health insurance can afford us peace of mind.

It would be wise to research and understand insurance options for your pet before you need it. If your pet is robust and healthy, it may make sense to hold off. If your pet is older or more prone to illness, having health insurance may save you a lot of money. Prepare yourself with the necessary knowledge so that you can make an informed decision. Find out what insurance companies are accepted by your vet. Get information from those companies, comparing plans, costs, and coverage. Determine what you can afford based on your financial circumstances. In this way you will be prepared to best deal with lapses in your pet’s health in a way that is compatible with your budget.

For more informational articles on how to keep your cat healthy and happy, visit http://www.healthy-cat-supplies.com

Kat Bartone is a writer, musician, computer technology instructor, internet marketer, and blogging enthusiast. She lives in Massachusetts with her cat Zoe.

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Posted on May 15th, 2008 in Business Health Insurance

I am an animal lover and have been since I was a child. Today I own a couple of dogs as well as four cats. As other pet owners would know you take on a huge responsibility when you decide that you want to own a domestic animal. Not only do you have to feed them good nutritious food you also need to provide them with regular exercise so that you can ensure that they remain healthy and free of ailments.

I am quite astonished that many pet owners ignore the opportunity to buy pet health insurance for cats. Statistics show that people who own dogs as well as cats are more inclined to insure their dog rather than their cat. I am not sure as to why they decide this, perhaps it is because they have the belief that because dogs are more active they are more likely to get injuries requiring veterinary treatment, rather than cats who are considered to be more homely and less likely to sustain injuries. In reality cats, even those that remain mostly indoors, are just as likely to require treatment for health problems as dogs.

In some cases it is cats who are more prone to having health related problems than dogs. Cats are inclined to suffer in silence, meaning that although they may have a serious health problem you may not necessarily realize because they don’t jump about complaining as is the case with most dogs.

Furthermore, cats are known to have an incredibly high threshold for pain and suffering. It is because of their ability to mask the fact that they have serious health problems that your cat may suffer right before your eyes and you may never even know it. A cat could well be suffering a life-threatening ailment for many years but if you don’t take it to the vet for regular checkups the problem may never be discovered.

In the case of pet owners who have more than one cat, if one gets sick it is highly likely to pass on the problem to your other cats resulting in you incurring quite sizable vet fees and ongoing treatment costs. So rather than insure your dog and ignore your cat you should go out and buy pet health insurance for cats as well. When you talk to the average pet owner you get a variety of different responses when you mention something as important as taking your cat for regular veterinary check ups. Often, people will say things like “Well, if there is nothing wrong with my cat then I usually don’t bother taking them to the vet”. This response shows that the cat owner is somewhat irresponsible.

Like humans our pets should be subjected to frequent check-up so as to maintain good health and identify any potential problems. Taking preventative measures for our animals is a much better option than having to source a cure. The cost of preventative animal health is also much cheaper than having to fix up a particular problem. With the peace of mind offered by pet health insurance for cats you will be able to control the cost of providing regular health checks for your much adored pet. Check out the prices for pet health insurance online for all your domestic animals - you will be pleasantly surprised at the small amount you need to pay for peace of mind.

For further details about pet health insurance for cats and general pet insurance information visit Family Pet Health Insurance.

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Posted on May 15th, 2008 in Business Health Insurance

A dog is a man’s best friend and the warm welcome you receive from your pet once you are back after a hard day at work, stands witness to this fact. The dog is one of the most loyal beings in your circle of family. A dog will still wag its tail after you have just given it a scolding, and will still be excited to see you after you had left it alone for the whole day. When you receive so much love and affection from your pet, it is only natural that you too would like to provide the very best for your pet. Keeping a pet does not only involve its food, games and grooming, it goes much beyond these things. Hence, having a dog health insurance would be the most feasible option for you and your pet under all circumstances.

Many reputed and reliable companies provide dog health insurance and it is up to the owner to select the plan that provides the most convenient coverage to his or her pet. The coverage can be for the regular expenses on a pet’s vaccinations and usual treatment by the vet however, there are other plans that go much beyond the basic. You could get an accident coverage, an insurance for the damage caused by your pet to a third person or their property, coverage for the advertisement when a pet gets lost and even insurance for canceled holidays due to a pet’s health problems. So when you choose a dog health insurance make sure that it fits into your requirements and expectations regarding your pet.

The advancement in medical science has made many veterinary treatments possible in today’s time however, most of these treatments like a kidney replacement or perhaps hip replacement, are complicated and involve a high expenditure. It may not be possible for pet owner to spend that many finances on the care and treatment of their pet even if they would want to. Hence it is best to go in for a dog health insurance so that your pet does not have to unnecessarily have to suffer due to a lack of funds. The best ways to go about selecting the right insurance company and the best plan for your pet is through the suggestion of your pet’s veterinary practitioner, yellow pages, and internet or through the reference of a pet owner who already has his or her pet insured.

While considering the right plan for a dog health insurance, it is important to keep in mind the breed of the dog, its age, gender, medical condition, etc. Once all these crucial factors have been taken into consideration, you are in a better position to select a plan that will work for you and your beloved pet. Even the premium that you pay for the insurance will work out to be an affordable and nominal account in comparison to the expenses that you would otherwise have to pay from your pocket. We often like to insure our precious assets like life, vehicles, house and property, etc. So it is equally important to get our pets insured which are as valuable to us as our own children.

Robert Scott is a veterinary doctor and through ages having been dealing in pet insurance. If you want to know more about Pet insurance,Dog insurance,Cat insurance,Pet insurance Online Dog health insurance you can visit http://www.insuranceforpets.net

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Posted on May 15th, 2008 in Business Health Insurance

Since veterinary costs are rising day-by-day, insurance policies have become the biggest necessity of all pet owners. In fact, these policies are helpful in lightening the financial burden of the pet owner; perhaps, this is the reason why most of the pet owners are buying health insurance policies for their pets. Such health insurance can be a topic of debate among pet owners but the fact is that all pet owners, who care for their pet’s requirements and want to provide them with quality medical facilities, buy these policies to secure their pet’s life. People, who are concerned about their pet’s health, know that a health insurance can save their pet’s life during serious illness or injury. These insurance policies cover a wide range of healthcare requirements of a pet, so that the pet owner may get relief from the burdensome medical bills of his or her pet. Owning a cat is the biggest pleasure of the world but one may feel really very bad when he or she is not able to take care of this sweet little creature just because of financial shortage. Cat health insurance is the only one solution that may help a cat owner in providing his or her cat with the best healthcare benefits.

Cat health insurance policies are just like human insurance policies and they also carry equal healthcare benefits. These policies cover all unexpected health expenses of a cat, so that the owner may not face sudden financial burden at the time of her injury or illness. There are people, who believe that paying premiums of their cat’s insurance just increases their financial burden, as their cat hardly requires medical check-ups and treatments. However, life is unpredictable and no cat owner can predict that his or her cat will stay healthy forever; therefore, they should not deny the benefits of a cat health insurance.

However, it is wise to analyze every aspect of cat health insurance polices but it does not mean that these policies are not useful. Analyzing these policies can help a pet owner in getting a clear idea about the processing of these policies. With this, the cat owner can know whether the selected insurance policy covers pre-existing health problems of his or her cat or not. Since there are some policies that do not cover pre-existing conditions, it is always advisable to select a policy that covers unexpected and pre-existing conditions of the insured cat.

There are various factors that determine the benefits of your cat health insurance. Age and physical condition are one of those key factors that decide on the benefit level of a cat insurance policy. These factors also helps the insurance company in setting the premium amount, as older your cat will be the higher premium amount you will have to pay for her policy. However, this premium amount never goes out of the budget of the cat owner, as the cat owner gets the privilege to choose the cat health insurance policy as per his or her capacity.

Robert Scott is a veterinary doctor and through ages having been dealing in pet insurance. If you want to know more about Pet Insurance, Cat insurance, Pet insurance Online,Veterinary pet insurance, Cat health insurance You can visit http://www.insuranceforpets.net

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Posted on May 15th, 2008 in Business Health Insurance

I have four cats and I am also an animal lover in general so I am always astonished at people’s attitudes when it comes to pet health insurance for cats or any other animals. If you own cats then pet health insurance for cats is something you should seriously consider as cats, even indoor cats, are just as prone to health issues as dogs and in many cases cats may be more prone than dogs.

If you have multiple cats, which many people that own cats do, then pet health insurance for cats makes even more sense because when something affects one of your cats there is a good chance it will wind affecting all of them and if you have four like I do then that can get very expensive. So if you own cats then do yourself a favor and get some pet health insurance for cats.

When you talk to the average pet owner you get different responses when you just mention something as important as regular veterinary check ups. People will say things like “Well if there is nothing wrong with my pet then I usually don’t bother taking them to the vet” or some such nonsense. People that own pets with that sort of attitude should have their pets taken away and given to pet owners with common sense.

Pets, especially cats, have an incredibly high threshold for pain and suffering. A cat will suffer right before your eyes and you may never even know it. A cat could be suffering for years with an ailment and if you don’t take it to regular vet appointments you may never know your cat is suffering. Pet health insurance for cats can help you be a better cat owner by not only making sure you get your cat to regular appointments because they are covered by the pet health insurance for cats but you can now afford any procedures and medications your cat may need because you pay that small fee per month for coverage.

Love ‘Em Or Hate ‘Em The World Has Lots Of Cats

Being a cat lover I could never understand people that hate cats and even like to torture and abuse cats. If you ever see a cat in that situation do the humane thing and rescue it and then do the decent thing and punch the offending human in the face. But you never know what will happen to your cat as it wanders the world in the case of an outdoor cat or as it wanders your house in the case of an indoor cat. Whatever may happen you are ready to care for your cat if you have pet health insurance for cats. No matter what comes up you will be prepared as any good pet owner should be.

Echo Wang is a contributing Editor for insurance pet. Find out which insurance pet products, treatments & solutions will continue to be beautiful at any time. Our site is dedicated to providing information about insurance pet well options so you can continue to do it perfect, if want to more information, please visit Pet Health Insurance For Your Cat

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Posted on May 15th, 2008 in Business Health Insurance

Many pet owners are asking about genetic coverage in pet insurance plans specifically do these insurers cover genetic conditions.

While some pet plans cover hospitalization, diagnostic tests, Surgery, Cancer treatment, dental treatment and prescription medications, some do cover alternative treatments such as hydrotherapy and chiropractic adjustments.

We come to the subject of Genetics these days with all the studies that are done on genes, it has now affected how insurers view the ” predisposition factor” in their policies. Different plans are rated for their annual limits such as $ 8,000.oo for one plan,

$ 12,000.00 for another type but take into consideration your deductible portion or co-insurance portions that you pay for each claim.

Costs of Dog Disease Treatments:

Various costs going to a veterinarian for conditions such as: Parovirus for a Pit Bull can run up to $ 9,500.00, or Ear Infections at around $ 5,000.00 for a poodle. We can all agree these costs are astronomical to an average family. A broken leg can cost for a Golden Retriever up to $ 4,000.00. Not to mention illness from bacteria, food poisoning, or diseases from our environment such as asthma. The cost on insurance on these health concerns increases for the type of coverage you seek, and it depends on your breed, and what coverage you can get from insurers. If you are seeking dog health insurance which includes genetic coverage you must include the wording that will cover genetic coverage in the plan you want to chose.

Genetic Conditions:

The definition of a genetic disorder or condition is a condition that is caused by abnormalities in genes at birth. Genetic defects may also be inherited by parents so you can see the need for buying a dog where you can actually see the parents and get a medial report from their veterinarian.

Some insurance companies will not cover you for ” genetic, or hereditary” conditions and chronic or ongoing conditions in my dog health research.

But you can have an ongoing condition which is not genetically based so you can see its all up to how your insurance company interprets these terms. It is generally all in the fine print, and there are ways to deny payment for a claim by the use of these broadly interpreted terms. Your veterinarian can get a firm approval before any treatment begins much like dentists do with dental insurance.

Unfortunately Insurance companies in my dog health research do not always have iron clad agreements in writing policies and many people have been left with no coverage at all and this is because some diseases fall into several categories.

Genetic conditions are generally what the dog is born with by its breed type for instance large dog breeds such as German Shepard’s or Great Danes are susceptible to hip dysphasia which is a “Hereditary Disease” that is it is inherited at birth. An English Cocker Spaniel is susceptible to Familial Nephropathy which is evident at six months to the first two years of life and shuts down the kidneys.

If your dog health plan does not cover ” hereditary diseases” you would have a hard time convincing your insurer that you did not know this and if you read the fine print it may not be covered for any claims associated with this disease.

Genetic Conditions in Labrador Retrievers:

This most popular breed has a whole host of genetic conditions such as: Arthritis, Hip Dysplasia, Developmental Bone and Joint Disease, Hepatitis, Heart valve Tricuspid Dysplasia, and others. This does not mean your dog will get these diseases it just means your dog may be prone or predisposed to develop these particular pet illnesses.

Insurance Tips:

1) Get a policy with a yearly limit not lifetime limits.

2) True Life insurance is for the life time of the pet which is best.

3)Your deductible should be a dollar amount not a percentage of the claim.

4) Watch for clauses on hereditary, genetic, pre-existing conditions
on your contract before you enter into a binding agreement.

5) Negotiate each plan with each insurance company -nothing is written in stone.

Many pet owners who are starting their own high yield savings Account for such costs and save for the future just in case which is what insurance is all about, just in case.

Whether you choose a pet health insurance plan or a savings plan the reason I created this site is to promote prevention. You can prevent sickness and diseases that will help your pet be healthier and live longer. Prevention will save you whopping sums of money on your veterinarian bills during the lifetime of your dog.

Teri Salvador is a freelance writer with a site primarily on dog health issues that offers frequently updated articles on natural remedies, pet product reviews and current articles on pet foods. You will read it first on DogHealth1.com even before CNN gets around to covering the story. Visit: http://www.DogHealth1.com

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Posted on May 15th, 2008 in Business Health Insurance

Health insurance plans have been forced to take action to contain costs of quality health care delivery as health care costs have skyrocketed. Health insurance premiums, deductibles and co-pays have steadily increased, and health insurance companies have implemented certain strategies for reducing health care costs. “Managed care” describes a group of stratgies aimed at reducing the costs of health care for health insurance companies.

There are two basic types of managed care plans; health maintenance organizations, or HMOs, and preferred provider organizations, or PPOs. So which health plan is best? How do you choose what type of health insurance best suits the health care needs of you and your family?

Both HMOs and PPOs contain costs by contracting with health providers for reduced rate on health care services for its’ members, often as much as 60%. One important difference between HMOs and PPOs is that PPOs often will cover the costs of care when the provider is out of their network, but usually at a reduced rate. On the other hand, most HMOs offer no coverage for health care services for out-of-network providers.

Both HMO and PPOs also control health care costs by use of a gateway, or primary care provider (PCP). Health insurance plan members are assigned (or select) a primary care practitioner (physician, physician assistant, or nurse practitioner). usually a family practitioner or internal medicine doctor for adult members or a pediatrician or family care practitioner for childern. The primary care provider is responsible for coordianting health delivery for plan members. Care by specialist physicians require referral from the primary care provider. This cost containment strategy is intended to avoid duplication of services (for example, the cardiologist ordering tests that have already been done by the PCP, or a sprained ankle being referred to an orthopedic) and avoid unnecessary specialist referrals, tests and/or procedures.

HMO and PPO plans also contain costs by requiring prior approval, prior authorization, or pre-certification for many elective hospital admissions, surgeries, costly tests and imaging procedures, durable medical equipment and prescription drugs. When such services are required, the provider must submit a request to the health insurance plan review department, along with medical records that justify the service. The request is reviewed by the health insurance company to determine whether the services are justified as “medically necessary” according to the health plan policy and guidelines. Review is usually performed by licensed nurses, and, if the reviewer agrees that the service is necessary, approval is given and the service will be covered by the health insurance plan.

As health care costs continue to rise, many indemnity health insurance plans, or “fee for service” plans are being forced to adopt some managed care strategies in order to provide quality health care and keep health insurance premiums affordable. And as long as health care costs continue to rise, the distinctions among PPO, HMO, FFS and other health insurance plans will become blurred. Rest assured, however, that managed health care is here to stay.

Kay Lowe holds a Master’s degree in health care and has 30+ years experience in the health care field. She is also webmaster for Health-Infosource.com, a website dedicated to disseminating health information.

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