How will you make the best choice for your health insurance? By understanding your options!
Here is a high-level review of the different types of health insurance plans. The right fit is different for each individual. So please give our office a call to discuss which type of plan may be best for you!
Health Maintenance Organizations (HMOs) and Exclusive Provider Organizations (EPOs)
Coverage is limited to a certain list of providers (called the network). This means you can only go to a doctor, clinic, hospital, or other medical provider that is part of the plan’s network. If you visit an out-of-network provider, you will be responsible for the full charge.
With some HMO plans, your care is coordinated through a primary care physician who must give you a referral to visit a specialist.
You may be charged a co-payment for certain services.
Preferred Provider Organizations (PPOs) and Point-of-Service plans (POS)
These types of plans give you a choice of provider, but certain providers are within the plan’s preferred network. You will pay more for service if you visit an out-of-network provider.
With a PPO, you may visit any doctor without a referral. With a POS, you may visit any in-network doctor without a referral, but must have a referral to see someone out-of-network.
Co-payments and co-insurance are common for these plans.
High Deductible Health Plan (HDHP)
HDHPs typically allow treatment by both in-network and out-of-network providers, with the deductible for out-of-network care being higher — and tracked separately — than the deductible for in-network care. Co-payments also will differ for in-network vs. out-of-network care.
Click here for a full description of HDHPs. If you have a HDHP, you can use a Health Savings Account (HSA) to lower your costs.
Catastrophic Health Insurance Plan
A catastrophic health insurance plan covers essential health benefits but has a very high deductible. It really serves as a “safety net” for a major medical event. Premiums may be very low, but you may pay thousands of dollars before your coverage kicks in.
Catastrophic plans are only available to people under age 30.