Starting a new job. My company pays 100% of my premiums for the HMO/PPO of my choice. What does this mean?

What do I pay if anything? Sorry to reveal my ignorance. I'm not good with employer/ employee insurance and how it works.

45 Answers

Relevance
  • 1 decade ago
    Favorite Answer

    That means if you quit, the Diva will have to take a flight to your house and drop kick you down a flight of steps.

    It means that they pay 100% of the normal costs you would pay for health insurance. You will not see a deduction for health care come out of your paycheck.

    The only thing you should be responsible for is your co-pay (a small portion, normally $10-20 paid out of pocket whenever you go to the doctor).

    Yo go girl! Awesome company to work for!

    Diva

  • 1 decade ago

    First off, the company is going to pay your monthly premiums with the insurance company. You will not have to make arragemts to have that taken out of your check. (Probably your immediate family too.) Secondly, aMO/PPO means the Physicans, Medical Centers, Labs, etc., has an agreement to except payment in the manner agreed upon. Not all Drs., Medical Centers, Labs etc., are on your plan. If you go out side your plan then you have a bigger out of pocket balanace. HMO is usually 80/20%. Meaning insurance pays 80% and you pay the 20%. But you have to stick with participating providers. If you don't use someone on your plan list, then you are penalized and have to pay more monies out of your own pocket. A PPO is basically the same situation. Generally, you pay a percentage of the bill with PPO. Insurance pays a percentage, and because you use a participating provider, they have a contractual amount that they have agreed on with your Insurance to write off. This amount can not be billed to the patient. After seeing a Dr., or being in a hospital, or using a Lab that is under your PPO/HMO plan, you will receive a EOB, (explanation of benefits) from the insurance company. On this EOB it will have all charges on it, showing what PPO paid, how much the Physician or facility has to write off, (the contratual agreement) and then a balance which is usually pretty small, that you will be responsible for. I personally, think a PPO is the best route. But of course there are people out here, that will not agree with me. Bottom line, HMO/PPO is a dedication of what Dr., Labs and Facilities you have to use. But with this insurance and using the facilities that are in agreement with HMO/PPO plan, is still a great insurance. Your employer should give you a hand book, and a list of participating Dr., so you can be prepared. Curious, is your new job with an Airline?

    Source(s): Medicare and Insurance consultant with a large hospital for over 10 years
  • Anonymous
    1 decade ago

    It means you got a good deal as most companies only pay about half.

    If you select an HMO your choice of doctors and medical facilities will be limited, but if you go to one you cost will be limited to a co-pay, which will probably be under $20.

    If you select a PPO you will be able to go to just about any doctor or medical facility, but in addition to the small co-pay you will have a cost share which is usually about 20% of the bill.

    If you aren't already receiving treatment from a specific doctor or medical facility I'd go with the HMO, but if you are receiving medical care now you need to make sure that they will take that HMO. If not then you need to either take the PPO or find a doctor/facility on the new HMO that can treat you. Good Luck!

  • Anonymous
    1 decade ago

    PPO= Participating Provider Option

    HMO=Health Maintenance Organization

  • How do you think about the answers? You can sign in to vote the answer.
  • 1 decade ago

    Not to worry about ignorance - if you don't ask questions, how will you learn? You should have a group administrator - find out who that person is & ask them all of the questions specific to what your employer covers. From what you've said, the company you work for will pay the cost of your HMO/PPO coverage. You won't have to pay out of your paycheck for that every month or every check, however they do it. If you were to choose some coverage that isn't hmo/ppo, then you will have to pay the premiums. HMO isn't bad - you have one dr you see for everything & if you need a specialist, they will refer you. PPO is a preferred provider organization - the dr you choose participates with that health insurance & agrees to accept the payment your insurance company makes & you won't be responsible for more than your coinsurance or deductibles. But talk it over with the group administrator - they can give you booklets & explain everything to you. The insurance company can even help you find a doctor you want to see, in your network, in your area.

    Good luck & congrats - it's really hard to find a company that pays for insurance now.

    Source(s): work for ins
  • 1 decade ago

    First of all. It takes a few minutes to understand HMO and PPO before you make our choice. Your Human Resources department should be able to explain to you in plain English.

    HMO stands for Health maintenance Organization which manage to save costs, so their premium is much less - of course there are inconveniences. The main advantage is when you are hospitalized which is very expensive. you probably pays nothing or a small deductible. On the other hand PPO which is Prefer ed Provider Organization which meăns you can chơose your own doctor ( within a group of Dr. affiliated to that PPO ) but then your premium is much higher, your co payment is higher, sometimes you have to pay up to 20%. For a Dr. visit, 20% is not much but you can go to the one you like ! right ! but how about a stay in hospital ( you broke your leg for example 0 which cost you 40 thousand, then you end up paying 8000 on your own. What is the heck of chơosing your Dr. anyway. Besides, the majority of Dr. sign up with most the big HMO such like Kaiser, Health Net, Blue Cross. You end up se eing the same one...probably.

    Secondo. Wow. Which company is that. It is rare to find one nowadays which offer full benefit like that. Please let me know, please... I have be unemployed for 6 months and am lơoking for work right now. My e-mail is

    npvc2003@yahoo.com Thank you

  • Anonymous
    1 decade ago

    That means you don't have to make any payments, monthly to have health insurance. That is a huge benefit. You will, however, have to pay for your deductibles, if any, and any co-pays (for example $10 for a prescription).

    PPOs allow you to see any doctor you want. PPOs rely on networks of doctors. If you see an in network doctor, your premiums and co-pays are less. You can see a doctor out of network too.

    HMOs restrict which doctors you can see. You can only go to doctors in the HMO network. The upside is there are typically little, if any deductibles in HMOs. And, your co-pays are minimized too.

    If you don't mind the hassle of being limited to doctors in network - HMOs are the way to go over PPOs unless you have an illness - in which case you might be better off with a broader network of doctors.

  • 1 decade ago

    It means that the company pays for all of YOUR premiums, but if you have a spouse/kids you will likely have to pay a percent of their premiums.

    It is an HMO/PPO which means it is managed care....you'll have to select a "Primary Care Physician" from their list of possible PCPs. If you go outside the "network" you'll have to pay higher co-pays and deducible.

    For any kind of specialty care at all, you have to first go to your PCP. Then they will decide whether to refer you to a specialist.

    The PCPs get incented to not refer you for more specialized care....meaning your regular doctor gets more money from the HMO/PPO if they can find ways to avoid you having to see a specialist....this is rationed health care that is not always in the best interest of the patient because the bottom line takes precedence over patient care.

    While it is nice that you aren't paying any premiums for your health care, you have to endure the rationed, managed care that is so frustrating for most Americans.

  • 1 decade ago

    Your company will pay your monthly payment to be a part of the insurance program. You will have to pay your own individual bills such as copays and deductibles. Make sure to read the information carefully though before choosing an HMO or PPO.

  • 1 decade ago

    Wow, it means you got a great deal! Most companies only pay a % of your premiums each month for your insurance and you have to pay the rest. You would still have a co-pay when you go to the doctor or get medications but that is way better than a co-pay AND a deduction from your pay for premiums!

Still have questions? Get your answers by asking now.