What distinguishes Limited Health Service Organizations from conventional health plans?

Limited Health Service Organizations are characterized by their specific focus on providing a narrower range of services compared to conventional health plans. One key distinguishing feature is that they often do not cover emergency services. This limitation is significant because conventional health plans typically include a broader array of medical services, including emergency care, to ensure that members have access to necessary care in urgent situations.

In contrast, Limited Health Service Organizations may offer services such as preventive care, outpatient services, or specific disease management but intentionally exclude emergency services, which can lead to gaps in coverage when urgent medical attention is required. This differentiating factor highlights the more restricted nature of the services these organizations provide, making them less comprehensive than traditional health insurance plans.

While comprehensive care is a hallmark of conventional plans, Limited Health Service Organizations do not share this requirement. These organizations also do not specifically limit their membership to small employers; they may serve a variety of groups, though often with a more restrictive benefit structure than what larger health plans offer.