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What Types of Health Insurance Are There?

on 29 May, 2018

Over 40 million Americans are without health insurance. Are you one of them? If so, it’s time to get yourself covered. Wondering what types of health insurance there are? Looking for something affordable?

Keep reading to learn more about the types of health insurance and how to get the best deal for you and your family.

Levels of Care

If you’re in the market for health insurance, it’s important to understand your options. Some insurance options cost more up front but offer more protection with a lower deductible.

Some plans offer a low monthly rate but have a high deductible and low coverage.

Your age, health, and other factors help determine what type of insurance you need.

The below designations are offered by many different insurance companies.

Keep in mind that the plans named after metals refer to the level of care within different types of insurance policies.

Platinum

Platinum insurance plans are the most expensive monthly plans.

That’s because they cover about 90% of your costs, leaving you to cover 10%. If you can handle a high monthly cost, then you’re well covered in the event of medical problems.

Gold

Gold is one step down from platinum and covers approximately 80% of average costs. You’ll cover the other 20%.

The gold level is less expensive than platinum but will cost more than the silver or bronze plans. If you have a family with young children, consider this option.

Silver

Next is the silver plan. On this plan, you’ll pay 30% of costs while the insurance company covers 70% of average coss.

Bronze

The bronze plans cover 60%, leaving you with 40% of average costs. Bronze plans are the least expensive monthly plans because they cover the least costs.

Now that you understand how the levels of care work, take a look at the types of plans.

Types of Plans

Most insurance plans offer the levels of care described above. You need to understand the types of plans before you shop for insurance so that you get the policy that best fits your needs.

Choosing insurance is confusing and overwhelming for a lot of people. You can enlist the aid of an insurance comparison platform to help find the best deal.

Health Maintenance Organization (HMO)

An HMO is an organization that offers a network of physicians, other providers, and facilities. You’ll have one physician who’s your primary care physician.

You’ll see this doctor for most of your health issues as well as your preventive exams. If you need to see a specialist, you’ll see your primary care physician first.

The primary care doctor gives you a referral to the specialist.

If you see any doctors or use any facilities outside the approved network, it will cost much more. In some cases, payment for your care may be denied if you fail to get a referral or use a doctor outside the network.

One of the nice things about an HMO is the lack of paperwork. You can see your primary care doctor without worrying about filling out claim forms.

Most HMOs don’t have a deductible. If there is a deductible, it’s usually low.

There’s usually a co-pay or co-insurance payment for each visit. Co-insurance requires you to pay a percentage of the cost of the visit, such as 10%. A co-pay is a standard fee, such as $20, for each visit.

Preferred Provider Organization (PPO)

PPOs are like HMOs in that you’ll want to stay within the network to receive the best coverage. Going outside the list of preferred providers will cost you more.

Expect to fill out claim forms if you go outside the network. With a PPO, you’ll have a wider choice of doctors with a little more freedom to choose what doctor you want to see.

You’ll also be able to see specialists from the preferred-provider list without first obtaining a referral.

PPOs usually have a higher monthly premium than HMOs. You’ll also have a deductible. There’s usually a co-pay or co-insurance costs as well.

Exclusive Provider Organization (EPO)

The EPO comes with a little more freedom to choose your doctors than the HMO. It’s similar to a PPO. Keep in mind that if you use an EPO, there is no coverage if you see an out-of-network doctor.

An emergency is the only time an out-of-network doctor will be covered.

Like the other plans, there are monthly premiums and co-pays or co-insurance. Not all EPOs require a deductible.

One thing you don’t have with an EPO is lots of paperwork. You won’t have to worry about filing a claim.

Point-of-Service Plans (POS)

POS plans are a combination of the HMO and PPO plans. A POS offers more doctors in-network than an HMO.

You’ll have a primary care doctor, like the HMO plan. Your primary doctor refers you to in-network doctors as necessary. If you see out-of-network doctors, you’ll pay more and have more paperwork.

Like all the plans, the POS has a monthly premium. You’ll pay a deductible as well as a co-pay or co-insurance.

Catastrophic Insurance

Catastrophic plans are for the young healthy individual who doesn’t need much insurance coverage. As the name implies, you’ll be covered in the event of a catastrophe.

The deductibles are high at around $8,000.

Care is covered at 60% or less of the average costs.

You’re entitled to preventive care at no cost. You’ll also receive three visits with your primary care physician before you need to worry about paying deductible costs.

Remember to keep track of all your medical expenses if you have a catastrophic insurance plan.

Catastrophic plans are only available to persons under the age of 30.

Health Savings Account with High Deductible

It’s possible you quality for a high-deductible health insurance plan that comes with a health savings account (HSA). Pre-tax dollars go into the HSA and can only be used for qualified medical expenses.

These plans can be used with a POS, PPO, HMO, or EPO.

Need Help?

Sorting through the many types of health insurance plans is time-consuming, confusing, and overwhelming. If you need help, why not bring in the experts?

Let someone else do the comparisons for you! Click here for more information.

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