If you are planning to change your health insurance coverage, you should know there are several different health insurance plans offered in the U.S.A. It is crucial you understand the difference between these insurance types and how they can be beneficial to you or your family. While choices for a new health insurance plan will vary, your specific health care needs and budget will help you narrow down the choices and make a worthwhile decision.
Major Medical Health Insurance Plans Available in the United States
Under the Affordable Care Act, health insurance plans must offer a minimal amount of coverage so that no one can be turned down. Doing so allows for health insurance to be available to everyone. These major medical health insurance plans are available in several formats. The three main types are HMO, PPO, and EPO plans.
HMO (Health Maintenance Organization) Plans
HMO plans are some of the most popular in the U.S. With this type of policy, the entire network of providers agrees to offer their services to you. You will need to select a PCP (primary care provider) from those that are available to provide you with basic health services and care. Most HMOs offer coverage for Preventative Care; however, to be seen by a Specialist, you will need a referral. Co-payments are required for all non-preventative medical visits, and there may also be an annual deductible.
PPO (Preferred Provider Organization) Plans
With a Preferred Provider Organization Plan (PPO), you and your family have the option to see any health care provider within the company’s network. This includes Specialists which you can see without a referral. In most cases, you are not required to choose a PCP with a PPO plan. There is usually a co-pay required for all non-preventative visits as well as an annual deductible. Those who see a Specialist regularly tend to prefer this type of health care plan.
EPO (Exclusive Provider Organization) Plans
With an Exclusive Provider Organization Plan or EPO, users have access to all providers within the network, including Specialists. While a PPO plan offers some coverage outside your network, an EPO plan typically will not, except in an emergency. EPO plans are suitable for individuals who are okay with limiting themselves to providers within a network.
Additional Health Insurance Options for U.S. Residents
Along with the three most popular health insurance options in the United States, HMO, PPO, and EPO plans, there are also several others for you to consider.
POS (Point of Service) Plans
A Point of Service or POS plan is a combination of an HMO and PPO. This plan will have you seeing a PCP for routine checkups and referrals. You can also have access to out-of-network providers if you are willing to pay a higher out-of-pocket cost. This is a versatile plan that is good for those who are willing to pay more for flexible coverage.
HDHP (High Deductible Health Plan) Plans
A High Deductible Health Plan offers cross categories of HMO, PPO and EPO coverage. This type of program has a high deductible you will need to meet prior to when your health insurance coverage goes into effect. These plans are suitable for individuals who need a low monthly premium and those who don’t plan to use their coverage extensively. These plans may be compared to a Health Savings Account.
Short-Term Health Insurance Plans
A Short-Term Health Insurance Plan doesn’t comply with the Affordable Care Act. But, if you missed the Open Enrollment Period, this type of policy can provide you with temporary coverage. There are limited benefits with this plan, and you may not receive the amount of essential coverage you need, especially if you have a severe health condition. This type of plan may exclude coverage for pre-existing conditions as well as preventative care. You should only consider this type of coverage for temporary use.
Gap Insurance Plans
A Gap Insurance Plan can offer individuals an emergency safety net when they have unexpected medical costs. If you don’t already have a significant medical policy such as an HMO or PPO, you can receive Gap Insurance coverage in the event of a severe health issue. You may also be eligible for Gap Insurance if you have a Short Term or Major Medical Policy, as a supplement source of protection. Gap Insurance plans can include Critical Illness Insurance, Accident Insurance, and Fixed-Benefit Indemnity Medical Insurance.
Ancillary Dental and Vision Plans
Out of all the insurance plans described here, most do not offer routine dental and vision care. Therefore, you may need a separate Dental and Vision plan to help cover the cost of this type of care. Be sure to consider the benefits of this coverage before you enroll and determine how much you or your family can benefit from it since Dental and Vision Plans are often very costly.
To learn more about the different insurance plans offered in the United States, contact the professionals of HealthQuoteInfo.com at 1-855-881-0430. Our licensed insurance experts will be happy to answer any questions you have.