I just moved from Canada to Cali. Benefits are confusing, what is better for my family, an HMO, EPO, POS, PPO?

Question

I can choose from a Kaiser HMO, an Aetna PPO, POS II, or Aetna EPO. This is all greek in Canada as there is gov't controlled health care. I have two small children and we do travel back to Canada so I would need something where I won't have to worry when out of country. Any thoughts or suggestions would be greatly appreciated.

I can choose from a Kaiser HMO, an Aetna PPO, POS II, or Aetna EPO. This is all greek in Canada as there is gov't controlled health care. I have two small children and we do travel back to Canada so I would need something where I won't have to worry when out of country. Any thoughts or suggestions would be greatly appreciated. Unfortunately I cannot keep my Canadian benefits because I am moving to the USA and I would have to go to Canada everytime I needed a doctor or dentist to use my Canadian benefits.

Answer 1

I've only heard about PPO and EPO. My hubby and I have EPO in Idaho. (I'm pretty sure it's the same company. I don't know if the plans vary from state to state though). Here's what I know about them (to the best of my memory).....

**EPO is good if you have lots and lots of medical expenses. Doctor co-pay is $20 when going to a regular doctor. $40 when going to a specialist. To the best of my knowledge, the insurance covers 90% of the other medical expenses (after the out-of-pocket deductible has been paid). BUT, it's only 90% coverage IF you see a doctor/specialist within the network. They have a list of doctors that you are allowed to see. If you choose a doctor that is not on the list, you HAVE to pay for everything. (That's the downside). Also, I think EPO has a higher premium than PPO.

**PPO has a lower premium. I think it's $20 co-pay for doctors. Not sure about specialists. This program does NOT cover 90% of expenses. I think it's closer to 60% in the network. But, they do cover some expenses if you choose a doctor that's out of the network. If your family is relatively healthy, this might be a better option.

Anyways, I've provided a link from a California company. It looks like it might have the information you need. If you don't find what you're looking for, you could try calling these insurance companies and ask for booklets that talk about the insurance programs they offer. Another place to ask these questions might be your employer or your drug store pharmicist.

Answer 2

I have what is called and HMO here in Massachusetts. You get to pick your own physican from a book. A primary for yourself and a Pediatrican for any children. I pay a $15.00 co-pay, and I pay a part of the premium weel\kly and the company i work for pays the majority. If you need any specialists yoru Primary physician will write a consult and have you go see him or her. You might ahve to wait a few months to get a phycical, but the good thing is if you dont like the doctor you picked, you can change at any time. Im sorry but I dont know what the other types that you mentioned. HMO stands for Health Maintanince Organization. Good Luck. It;s so much better then Canadian and English Socialized Medicine.

Answer 3

in case you do not have already got a dating well-liked by a physician, the HMO is the extra suitable thank you to flow. in case you have a physician, you will flow with the HMO as long as your physician is a member. With the HMO you're sacrificing a number of your selection in service selection, yet you acquire fee reward. With the PPO, you get extra possibilities, yet you pay extra suitable for the privilege.

Answer 4

All american health care is a POS (Piece of something) If you can, you should try to keep your Canadian benefits. If not, you'll have to spend several weeks straight waiting on hold and asking questions of the random receptionists that just happen to talk to you until you have half a clue as to what the different benefits are. If you're lucky it will only take one week of solid waiting on the phone to get straight answers.