PIH Health Offers Tips on Selecting Health Plan Options


Whittier, Calif., Oct. 04, 2017 (GLOBE NEWSWIRE) -- Most employer groups offer their health insurance open enrollment during the fall and early winter seasons with a January 1 effective date. PIH Health experts share these three tips for employees when selecting health plan options:

  • Do your research—thoroughly. Not all health plans and providers are alike, be sure to select a plan that will meet your/your family’s health needs.
  • Choose a primary care physician (PCP) who will coordinate all of your care. Your selection will determine the quality of care you will receive for the upcoming year.
  • Keep in mind that when you choose a doctor and medical group, you are also choosing the hospital where you would potentially be admitted and treated.

There are many health plan options but beneficiaries generally choose from two different types: a Health Maintenance Organization (HMO) and a Preferred Provider Organization (PPO).

1. HMO: This plan tends to offer lower monthly premiums with a limited network of physicians and hospitals available to plan members. Beneficiaries must choose a primary care physician (PCP) who will coordinate all care. If a specialist is required as a part of the patient’s healthcare, he/she must be referred by their PCP.

2. PPO: This plan gives access to a larger provider network and the option to go out of network by paying a higher co-payment. Monthly premiums and out-of-pocket costs tend to be higher with this plan, and beneficiaries will be responsible for managing and coordinating his/her own healthcare needs. Patients can also self-refer to specialists.

“It’s important to know that each health plan and medical provider is different,” says Roberto Madrid, MD, Family Medicine, PIH Health Physicians. “Doctors and hospitals will vary in degrees of experience and expertise, and certain health plans may not offer all of the benefits needed, so it’s important to take the time to research thoroughly.”

For information, or to find a doctor in your area, visit PIHHealth.org/find-a-doctor or call patient services at 1.888.365.4450.

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About PIH Health

PIH Health is a nonprofit, regional healthcare network that serves more than 2.1 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Hospital - Whittier and PIH Health Hospital - Downey and features numerous outpatient medical offices, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, women’s health, urgent care and emergency services. Recognized by Truven Health Analytics and Hospitals and Health Networks as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology, PIH Health invests millions each year in community education and free and low-cost services to support those with the greatest need. For more information, visit PIHHealth.org.

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