Common Types of Insurance Plans

Navigating health insurance can feel overwhelming, especially with so many plans available. Understanding the basics of common insurance types can help you make informed decisions and maximize your benefits. 

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Here’s a quick overview of the most common types of health insurance plans.

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Health Maintenance Organization (HMO)

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HMO plans are designed for patients who prefer coordinated care through a network of doctors and facilities. They typically require you to choose a primary care physician (PCP) who manages your care and provides referrals to specialists within the network. HMOs often have lower premiums and out-of-pocket costs but offer less flexibility in choosing providers.

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Preferred Provider Organization (PPO)

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PPO plans provide more flexibility in choosing healthcare providers. While you save money by visiting in-network doctors, you can also see out-of-network providers, usually at a higher cost. PPOs don’t typically require referrals to see specialists, making them a good choice for patients who want more freedom in managing their healthcare.

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Point of Service (POS)

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POS plans combine features of HMOs and PPOs. Like an HMO, you’ll need a PCP and referrals for specialists. However, similar to a PPO, you can choose out-of-network care, though it will cost more. POS plans offer balance but require careful attention to network rules.

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High-Deductible Health Plan (HDHP)

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HDHPs have lower monthly premiums but higher deductibles. These plans are often paired with Health Savings Accounts (HSAs), allowing you to save pre-tax dollars for medical expenses. They’re ideal for those who rarely need care or who want to save on premiums while planning for potential healthcare costs.

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Choosing the right insurance plan depends on your health needs, budget, and preferred level of flexibility. Review plan details carefully and ask your pharmacy or healthcare provider if you have questions — they’re here to help!

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The information on this site is for informational purposes only and should not replace direct medical advice, diagnosis, or treatment from your doctor or another qualified healthcare provider.

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Sources:

“Health insurance plan & network types: HMOs, PPOs, and more.” U.S. Centers for Medicare & Medicaid Services.