One of the first questions asked by consumers considering the purchase of short-term medical (STM) insurance is whether they can choose their doctors, hospitals, or other medical providers. The short answer is yes!
What is STM?
Short-term medical (STM) insurance helps people bridge gaps in coverage. These periods of transition occur, for example, when someone loses their job. Other reasons you might buy STM include:
- If you're a student switching off your parent's plan
- If you're a retiree who needs coverage before beginning Medicare
- If unexpected changes force you to wait for insurance with a new employer to begin
Short-term medical insurance is designed to provide protection for consumers needing coverage for 12 months or less. While STM policies are fairly basic in their level of coverage, the benefit is that they're also quite affordable. The younger you are, and the fewer dependents you have, the less expensive the policy will be.
What are HMOs and PPOs?
Within some Health Maintenance Organizations (HMOs), medical providers are actually employees of the HMO, and they may practice under the same roof. In Preferred Provider Organizations (PPOs), diverse providers contract with the PPO network.
In both cases, however, the organization controls what the provider can charge for its services. This is appealing to the patient, who usually derives a cost benefit by seeking care within the HMO/PPO.
Many health benefit plans also offer a greater degree of coverage (80% in-network benefits versus 60% out-of-network, for example) to those receiving medical care within a specified HMO/PPO. The provider benefits through a guaranteed flow of patients.
While HMOs/PPOs operate under the same basic principles to control cost and ensure quality of care, there are variations in the means used to achieve this. Some HMOs are "closed" and provide no benefits outside the network, or the patient may need a written referral to go outside the network for non-emergency care. This places the HMO in the role of a gatekeeper with heavy influence over access to care.
If choice of medical providers is a key factor in your health benefit policy, short-term medical insurance is advantageous.