Do you have health insurance? Are you shopping around for the best coverage, or trying to understand your employer-based insurance?
No matter your situation, knowing what’s out there can help you get the care you need!
It is beneficial to understand the different types of health insurance. You can check out our guide right here to learn more.
Five Major Types of Health Insurance
When it comes to insurance, there is a mountain of options out there. If you are an employee seeking insurance coverage, there are the five major types of plans you will encounter.
A Health Maintenance Organization (HMO) policy is a type of group insurance usually offered through an employer. HMOs generally come with lower deductibles, which is nice. However, these plans are notorious for how restrictive they are.
In an HMO, you are limited in the providers you can see. Often, you are forced to choose a primary care physician (PCP) and can only see specialists per the provider’s referral. Many HMO’s don’t provide coverage for any type of provider that’s out-of-network.
Nevertheless, HMOs provide a broader range of preventive services, like checkups and immunizations, than other plans and serve as a viable option for many employers.
Another type of group health insurance is the Preferred Provider Organization (PPO) plan. A PPO is similar to an HMO because you have to choose your doctor from a list of network providers. However, you do have a bit more flexibility since a PPO does not require that you select a PCP.
In a PPO, you are also free to seek out specialized care without a PCP referral first. Also, it is possible to get out-of-network care, though you would be subject to a higher copay and deductible. With a PPO, you have an annual minimum deductible you must meet before the coverage kicks in (unlike an HMO, where there is no such deductible).
A point of service (POS) plan shares some of the features of the HMO and PPO. With a POS, you can choose your provider as long as they are in the network. Also, POS plans allow for you to receive the same coverage out-of-network as long as your PCP was the one who referred you.
Many POSs allow for preventive care, and some even include health improvement programs like weight loss or smoking cessation workshops.
With so many types of health insurance coverage out there, it’s critical that you know the difference.
An exclusive provider organization (EPO) is similar to an HMO. An EPO focuses on a small network of providers you can choose from, and tends to cost less in terms of copays and deductibles.
Also known as “fee for service” plans, indemnity plans are what you may typically think of when it comes to insurance. While you may need to stay in-network for your care, the network is often more extensive. With near-complete autonomy, you pay for the care you receive; then, your employer may reimburse you.
If you are employed, find out what types of health insurance are available to you, then get covered! You never know when you’ll need it.
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