Navigating the world of health insurance can be daunting, especially with the many options available. Various types of health plans may come with their own features and considerations. This requires you to understand your options comprehensively to ensure that certain limitations or exclusions do not leave you lacking the necessary coverage.

Common Types of Health Insurance

There are many different types of health insurance plans, and understanding them may help you decide which best suits your needs. Consider the following guidance:

• Health maintenance organizations (HMOs)—HMOs are typically known for their emphasis on preventive care and cost containment. Under an HMO plan, you're required to choose a primary care physician (PCP) who manages your health care needs and provides referrals to specialists within the network. Out-of-network care typically isn't covered, except in emergencies. While HMOs often have lower premiums and predictable out-of-pocket costs, they offer less flexibility in choosing health care providers.
• Preferred provider organizations (PPOs)—PPOs generally offer more flexibility than HMOs. You're not required to choose a PCP and you can see any health care provider, though staying in-network typically results in lower out-of-pocket costs. PPOs also cover some out-of-network care, albeit at a higher price. These plans may be ideal for individuals who prefer balancing cost savings and provider choice.
• Point of service (POS)—POS plans combine elements of HMOs and PPOs. Like HMOs, you select a primary provider who coordinates your care and provides referrals. However, you can seek care out-of-network, although at a higher cost. POS plans offer more flexibility than HMOs but may come with higher premiums and out-of-pocket expenses.
• Exclusive provider organizations (EPOs)—EPOs may resemble HMOs in that they typically require you to select a primary care physician and receive care within the network. However, they don't usually mandate referrals for specialist care. Unlike HMOs, EPOs don't cover any out-of-network care except for emergencies. While EPOs offer lower premiums than PPOs, they may limit your choice of providers.
• High deductible health plans (HDHPs)—HDHPs are characterized by high deductibles and lower premiums. These plans are often paired with health savings accounts (HSAs), which allow you to save pre-tax money for medical expenses. While HDHPs offer significant cost savings for healthy individuals, they require you to pay higher out-of-pocket costs before insurance coverage kicks in. HDHPs are popular among those who don't anticipate frequent healthcare needs and want to take advantage of tax benefits through HSAs.

Get the Right Coverage

Choosing the right health insurance plan involves considering your health care needs, budget and preferences for provider choice and flexibility. Contact the knowledgeable professionals at Matt Roenker Insurance Agency to begin exploring major medical, short-term, HSA, Medicare Supplement and other health plans.

This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.