There are different types of health insurance plans that meet different needs. What are they and why do you need them? Here are some quick summaries.
HMO: Health Maintenance Organization – A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.
EPO: Exclusive Provider Organization – A managed care plan where services are covered only if you go to doctors, specialists, or hospitals in the plan’s network (except in an emergency).
PPO: Preferred Provider Organization – A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan’s network. You can use doctors, hospitals, and providers outside of the network for an additional cost.
POS: Point of Service Plans – A type of plan in which you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. POS plans also require you to get a referral from your primary care doctor in order to see a specialist.
Catastrophic Plans – People under 30 and people with “hardship exemptions” may buy a “catastrophic” health plan which protects individuals from the worst-case scenario but not much else. You’ll likely pay all your medical expenses up to a certain amount (your deductible) which is usually a few thousand dollars.
Make sense but you’re still not sure how to choose the right plan for you? I highly recommend calling Jennifer Goedken at (480) 773-2068 for a conversation on your specific situation. I have worked with her for years and have come to trust her completely. Not only does she help my husband and I with our insurance needs on a regular basis. Call Jennifer with your questions!
Jennifer Goedken is a licensed health insurance agent, in the state of Arizona, license #: 921010. This information is not intended to be legal advice or a complete instruction on any one topic regarding health insurance.