Healthcare Plan HMO PPO Traditional Indemnity

Healthcare Plan HMO PPO Traditional Indemnity

What is the plan year (effective dates)?

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Is your plan an HMO, PPO, traditional indemnity or other type of plan? How do you know this; where did you find this information?
Where does a co-pay apply within your coverage? How does co-pay impact your decision to access healthcare?
What is a deductible, in your policy what is your deductible?
Where does co-insurance apply within your coverage? How is co-insurance different from co-pay?
Are you required to identify a PCP when you enroll (a “gatekeeper” model)?
Where does pre-certification or pre-authorization apply within your coverage? How does this requirement impact your decision to access healthcare?
Describe the use of a formulary when a policy has pharmacy benefits, does your coverage provide this service?
What (if any) wellness benefits are covered in your plan?
What is meant when a policy has “out of network” stipulations, does this impact your decision to access healthcare?