Differences Between Open Access Health Care Plans

Many HMOs do not allow participants to visit doctors who are not on the HMOs approved list of providers. While most  open access plans allow plenty of options about medical providers, many people feel that the options were too restrictive. HMO providers eventually responded the requests for patients enrolled in them to have more choices.

What are Open Access Plans?

HMOs that offer open access plans do not restrict the choice of physicians of the people enrolled in the plan. As long as the doctor's office or hospital accepts the insurance company, a patient only needs to cover the co-pay and part of the premium.

Selecting an Open Access Plan

Open access plans usually cost a little more than a plan from a normal HMO would, but that is because the insurance company must cover the cost of services that might cost more when doctors outside of the plan offer them. The important things to consider are the cost, level of coverage, and how widely the plan is accepted. These are things that should be considered when purchasing any type of health plan, and apply to more than just picking an Open Access Plan.

Am I Restricted in Choice of Doctors?

These plans are designed to give patients as many choices as possible, so their will be few restrictions placed on health care providers that a person in the plan chooses to see. There may be some limitations based on the type of insurance that a doctor or hospital will accept.

Which Companies Offer Open Access Plans?

Aetna, Cigna, Blue Cross/Blue Shield and many other insurance companies that offer HMO health insurance are now offering this type of coverage. The details of the coverage and the benefits of each company's plan can be found on their respective web sites.

What About Limitations on Treatment?

Open access plans will only pay for the services covered by the HMO. If a patient needs experimental procedures or medications, he or she will have to find another way to pay for them. Anything that is on the approved list of treatments by the insurance company will be covered partially at least.