Hmo,ppo,pos, Open Access Plus

Ins155

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Can anyone tell me what does an "open access plus plan" fall under... HMO,PPO,POS etc. I have an open access plus plan through my employer and I can go to any doctor that accepts my insurance without a referral even specialists without ever seeing a primary physician. All I pay is a co-pay.
 
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Can anyone tell me what does an "open access plus plan" fall under... HMO,PPO,POS etc. I have an open access plan through my employer and I can go to any doctor that accepts my insurance without a referral even specialists without ever seeing a primary physician. All I pay is a co-pay.

It's an HMO with direct access for office visits within the medical group. Be careful in that it may still require referrals for tests, hospital, etc.

Rick
 
I have to say, I have never had to worry about any tests or referrals at all except for my co-pay. I've had surgery and my son has had (5) surgeries and never paid anything other than my co-pay. After reading the "prelicensing" material for my L&H license, I was confused as to where my own health insurance would fall under. Several times doctors offices staff would tell me "you need a referral for this etc." and I would argue that I do not need any referrals, only to have them check with my insurance and then apoligize to me saying "sorry you don't need a referral but most of the time people do." Also a family member works for a doctor as an office manager and she said because its "open access plus" it is not an HMO.
 
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I have to say, I have never had to worry about any tests or referrals at all except for my co-pay. I've had surgery and my son has had (5) surgeries and never paid anything other than my co-pay. After reading the "prelicensing" material for my L&H license, I was confused as to where my own health insurance would fall under. Several times doctors offices staff would tell me "you need a referral for this etc." and I would argue that I do not need any referrals, only to have them check with my insurance and then apoligize to me saying "sorry you don't need a referral but most of the time people do." Also a family member works for a doctor as an office manager and she said because its "open access plus" it is not an HMO.
Then why did you ask about it?

Rick
 
Because I thought I would ask someone on here that would know the business better than she does. Was I wrong for asking? You say, why do I ask then? Now I have you who say it is an HMO and her who says it is not. I believed it was, now that you also say it is I tend to believe my original feelings that it is an HMO unless someone else on here convinces me otherwise.
 
Because I thought I would ask someone on here that would know the business better than she does. Was I wrong for asking? You say, why do I ask then? Now I have you who say it is an HMO and her who says it is not. I believed it was, now that you also say it is I tend to believe my original feelings that it is an HMO unless someone else on here convinces me otherwise.
Fair enough. If you find it other than an HMO please post the information.

But, since a PPO never needs referrals, by definition "open access" does not apply. Same with a POS. It simply combines HMO and PPO.

The only thing left is an HMO. A "closed access" would be the traditional HMO. Wait for a referral until you are too sick to be cured.

Didn't mean to jump on you but it seemed like you had an answer and wanted to accept that and really wasn't asking for information.

Rick
 
No problem. Thanks for your feedback. Once again I believed it was under an HMO, she thought differently. So I thought where better to go and get the answer than on this site. Thanks again.
 
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