Page 64 - The Informed Fed--Hearn Wealth Management

HDHP PPO/FFS HMO
Red tape
/paperwork Lots Some Almost none

Emphasis on
keeping you Cost Pre-approval Non-hospital
out of the incentives treatment first

hospital
Choices of Some are In network Must use

doctors, network only; reduces cost; in-network
hospitals and others pay out-of-network providers; no
other something provides coverage for

providers for out-of- increased costs out-of-network
network
Use case

management Limited Limited Substantial

In terms of paperwork, an HMO is the easiest to deal with, while the
High-Deductible Health plan involves more paperwork and pre-
authorizations. The High-Deductible Health plan provides incentives to

the plan participant in taking responsibility for their care, while the PPO
and Fee-for-Service plans require pre-authorization, and the HMO

endorses non-hospital treatments. All three types of plans require you to

responsibility to understand what is required by the plan in order to avoid

unnecessary out-of-pocket expenses for yourself.
Each of the High-Deductible Health Plans and the PPO/FFS have
limited case management capabilities. This means you will be responsible

for managing more of your

anesthesiologist and any other medical professionals who might consult

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