Know the types of health insurance

Know the types of health insurance

Health services offered in the country are expensive and may cost several hundred or thousands of dollars. Therefore, it is recommended to seek and opt for health insurance with great coverage. But getting health insurance is not easy as there are several plans in the market offering a variety of features. It is important to be aware of the different types of health insurance before you choose a plan.

Types of health insurance

Health maintenance organizations (HMOs)
An HMO offers you a network of participating healthcare providers and facilities. Though there is less freedom to choose your healthcare providers, it provides many benefits such as lower co-payments, less paperwork, and more coverage of preventative care. A primary care doctor coordinates your care, but you will require a referral before you can see a specialist.

Preferred provider organizations (PPOs)
PPOs offer a large network of participating providers giving you more flexibility for selecting a provider. You may also see out-of-network doctors, but you will have to pay more out-of-pocket. In this type of health plan, you are not required to choose a primary care provider, and you can see specialists without a referral.

Exclusive provider organizations (EPOs)
An EPO covers only the costs of services from doctors, specialists, and hospitals in its network. If you do not want the hassle of obtaining a referral to see a specialist, an EPO is a good option. An EPO does not include coverage for out-of-network care except in an emergency. That means you will have to pay the full cost of services. EPO offers low monthly premiums but may have high deductibles. EPOs cost less than PPO plans.

Point-of-service (POS) plans
POS has a combination of both the HMO and PPO plans. POS also has a small network of participating providers like the PPO plan. The in-network costs are lower, like the HMO. Like PPO, you can choose either in-network or out-of-network specialists. But before you see a specialist, you are required to get a referral. Also, with out-of-network doctors, your share of costs will be higher.

Choosing a health insurance

Choose the marketplace for buying health insurance
Most people get health insurance through their employer. You can also shop on your state’s public or federal marketplace. One important thing to remember is that you can buy insurance through the marketplace during the open enrolment period that begins in mid-November and lasts until February. If the enrolment period is over, you have to purchase through a private exchange or directly from an insurer.

Choose from the different health insurance plans
By choosing the right health plan, you can avail of the best health care system. Not all insurance plans will cover all your healthcare needs. Therefore, it is important to compare the different common types of policies -HMOs, PPOs, EPOs, or POS plans. The type of plan you choose will dictate the approach for the treatment and the out-of-pocket costs. HMO is the cheapest type of health plan, whereas PPO or EPO plans are ideal for those who want the freedom to choose their specialists.

Compare out of pocket costs
Out-of-pocket costs can affect your total spending on health care. Beyond your monthly premium, costs such as deductibles, co-payments, and coinsurance can raise you’re the amount you need to pay. Usually, the lower the premium, the higher is the out-of-pocket costs. Also, some plans have lower out-of-pocket limits. Once you reach the limit, you do not have to pay co-payments or coinsurance for the rest of the year except the premiums.

Compare the plan benefits
After you have chosen your options, compare each plan and its benefits. Some plans may offer physical therapy, mental health care, or emergency coverage. Choose the plan that provides the best coverage and meets your health requirements.

With an understanding of the different types of health insurance plans, you can make an informed decision and plan a healthy future for yourself and your family.