Confronted with the options of PPOs, HMOs and EPOs, choosing a health plan
can seem like digging into a bowl of alphabet soup. But it doesn't have to
be so confusing. The Internet offers a wide range of sites that
can help you make sense of it all.
"The Web expands the information available about plans," said Carolyn
Clancy, M.D., director of the Center for Outcomes and Effectiveness
Research, a division of the government's Agency for Healthcare Research and
Quality. Dr. Clancy cites two major challenges: determining the quality of a plan and
weighing what features are most relevant to you.
When possible, seek information from unbiased third parties,
such as government agencies or independent rating groups. To narrow down your options, follow these strategies:
Assess Your Health Needs
The search for insurance should start with your own needs.
Consumers Union, publisher of Consumer Reports, offers a
Choosing a Health
Plan page that presents
questions you should consider. If you have a chronic condition or costly
medications, for instance, those should factor into your decision.
Understand Your Options
There are several varieties of insurance plans. Most familiar is the
indemnity (fee-for-service) plan, in which the client has a choice of
doctors and submits a claim to the provider. But managed care options like HMOs and PPOs are becoming more and more
common.
The Agency for
Healthcare Research and Quality explains the options
with
Choosing and Using a Health Plan.
Because the services and fees
offered by HMOs can vary widely, check out the Consumer Reports article
"Is an
HMO right for you?"
Compare Services
The National Commission for Quality Assurance
evaluates how different plans rate on
access to services, qualified providers and more. Healthgrades.com also provides comparisons.
The Web sites for individual providers can also help you
sort out differences.
"Many plans are accredited by the NCQA, so if a plan does well, it would
likely advertise that on its site," said Dr. Clancy.
--- M. Magnarelli
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