The Great Acronym Game
Medical Insurance in California

Every day, people across California are searching for the right medical insurance for themselves and their families. But researching medical insurance sometimes can feel like trying to decipher the Internal Revenue Service Code. The terminology can make your brain hurt and shrivel to the side of a green pea. And when so much of that terminology shows up in acronym form, it can feel like you’re read a foreign language.

Fear not! Here’s a primer in medical insurance acronyms that will have you well versed in no time.

HMO – No, it’s not a synonym for evil incarnate. It stands for Health Maintenance Organization. This is a popular option in group health insurance plans like those offered by many employers. Insured policyholders pay a monthly premium and then can just pay a small co-pay for doctor visits, preventive care and medical treatment. The downside is that you’re limited to physicians and facilities within the HMO’s network. This is how the HMO keeps is costs of doing business down. An HMO plan also requires the insured to select a primary care physician to take care of your basic health needs and through whom all referrals to specialists must pass. The only time you can receive treatment without a referral is for emergency room visits.

PPO – A Preferred Provider Organization medical insurance plan is a bit more flexible than an HMO but also costs more. With this type of plan, California policyholders can visit doctors and medical facilities that are out of network, though only a percentage of those out-of-network visits are covered by the policy. Also, referrals from a primary care physician are not necessary. Many people prefer this type of plan because it isn’t as restrictive.

POS – A Point-Of-Service plan is a hybrid between the HMO and PPO, combining the selection of a primary care physician like and HMO and the allowance of out-of-network visits like a PPO. Despite being able to make out-of-network visits, this type of medical insurance plan requires you to pay most of those costs out of pocket unless you are referred out of network by your primary care physician.

COBRA – Don’t bring out the snake charmers quite yet. COBRA doesn’t have anything to do with reptiles. In fact, you might want COBRA in your corner if you find yourself in the no man’s land between health insurance policies, as when you’re between jobs, you’ve become unemployed, you’ve divorced or to protect your family in the case of your death. The Consolidated Omnibus Budget Reconciliation Act of 1985 allows you to continue your medical insurance coverage with your former employer at your own expense if you leave voluntarily or are terminated for any reason other than gross misconduct. This coverage can be continued for up to 18 months until you have other insurance in place. There are lots of rules and restrictions regarding COBRA coverage, not to mention it’ll be a shock to your wallet compared to what you’re used to paying, so be sure to research COBRA coverage fully before signing up.