A contract requiring an insurer to pay some or all of a person’s healthcare bills in exchange for a premium is known as a medical plan. A medical plan would cover the insurer’s medical bills such as surgery and prescriptions. The thing is, medical care can be ridiculously expensive. Some people might not be able to pay using their own money as they might have other responsibilities that would need more money. This is where a medical plan comes to the rescue. A medical plan can pay the care provider directly, or give compensation in case of any injuries or accidents happen to the insured. Youngsters especially are highly advised to get a medical plan. If any of you readers are interested to buy comprehensive medical plan for young adults Malaysia, you are very welcome to do so.
The Many Types of Medical Plan
There are four common types of medical plans that we would usually encounter. These plans have their own pros and cons, hence why you should always think thoroughly before making a purchase. The plans being discussed are:
- Health Maintenance Organization (HMO)
An HMO is a type of medical plan that normally only covers care provided by contracted doctors or those who work with the HMO. Those who are in HMO must select a Primary Care Physician (PCP) from the HMO’s network of doctors. The primary care physician (PCP) manages care by referring patients to other doctors or specialists in the same network. Except in cases of emergency, it usually does not cover out-of-network care. To be covered by an HMO, you have to live or work within their designated service region.
- Exclusive Provider Organization (EPO)
An EPO is almost the same as an HMO. The insurer gets paid by them if care is obtained from the network providers for EPO. Normally, there is no coverage that will be given for any service that is acquired from non-network providers. There is a slight difference between an EPO and HPO. EPOs do not obligate the participants to select a PCP. They wouldn’t even have to meet a PCP or get a referral just to get paid.
- Preferred Provider Organization (PPO)
A PPO is the most popular medical plan among the others. This is due to the special benefits awaiting the participants. Those with this plan will receive benefits despite seeing a PPO network doctor or even a non-network doctor. Contracted medical professionals and health insurance companies are the core of the PPOs networks. PCP participants are not obligated to select a PCP or even meet their selected PPC. They will still get a PCP referral and receive the benefits.
- Point-of-service (POS)
Those who are involved in this plan would still obtain advantages if they go and meet either a POS network doctor or a non-network doctor. Just like PPOs, they have to use their own money when receiving network care. This is because the POS network providers have made an agreement to count the discounted fees. However, the participants are obligated to select a PCP and see them so that they would acquire all the benefits promised to them.
These are only a few types of medical plans that exist in Malaysia. If you have yet to choose which plan is the best for you, you might want to think about it deeply and thoroughly. Although some of them are quite expensive, the advantages and benefits offered are worth it. Therefore, you can always make up your mind after you seek advice from the professionals.