Posted September 6, 2013 | Filed under topic Health Insurance Information
When you submit your information to get a health insurance quote, you may be deluged with a dozen or more plan options. While you will want to review all of the information for the plans that seem like the best fit, you also want to be able to skim past health insurance options that do not fit your needs. To do so, it helps to have some understanding of basic plan types. Here are four of the most common:
Health Maintenance Organizations (HMO)
This was the first type of plan that insurers offered to the public. They are usually the first option for people who get coverage from their employer, but many are also available for family or individual insurance customers. HMOs require that a person choose their primary physician. Outside of regular office visits, the doctor is also responsible for referring patients to any specialists. There may be a significant difference between costs for visiting healthcare professionals in the insurance company’s network and outside doctors.
Preferred Provider Organizations (PPO)
The PPO plans that come up when you get a health insurance quote are likely to be more expensive than other options but they cost more because they have more flexibility. You can see any doctor that is in-network without paying additional costs. In addition, if you want to see a surgeon or an otolaryngologist, you do not have to see your family doctor before you do so. Keep in mind that like an HMO, PPO plans also rely on networks, although they also negotiate rates with other doctors that will be less expensive than going outside your network with an HMO.
Exclusive Provider Organizations (EPO)
EPO plans offer similar flexibility to PPO options but will come with less expensive monthly premiums and for a good reason. There are no out-of-network negotiated rates. While you can go see other doctors or healthcare specialists, you will be paying for the entire bill out of your own pocket. These plans are good options for people who see that their doctors and other healthcare professionals work with the insurance provider. Otherwise, your medical bills may erase any savings on your monthly payments.
Point of Service Plans (POS)
For people who are comfortable with doing paper work, POS plans are likely to be the least expensive options available to you. You have to choose a primary care physician like an HMO plan, but you submit claims for other medical visits and testing that are not covered under the plan. If you are healthy and have no family history of medical conditions this can be a strong option.
Once you pick the right type of plan, you will want to review the coverage information. Be sure to check that any doctors, psychiatrists or specialists you visit are within the network. If you travel, look to see what coverage is available for out-of-network providers. Finally, come up with an average year for you for healthcare needs. If you regularly get the flu or bacterial infections, you will want to compare the costs of doctors visits and prescription drug coverage before you go back and compare monthly premiums to come up with total annual healthcare costs.