The Different Kinds of Insurance Plans

Patients today have many choices when it comes to their health insurance. While being spoiled for choice can be great, it also leaves many patients uncertain about which plans are best for their financial and healthcare needs.

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Let’s explore the common types of insurance plans generally available to patients.

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Common Types of Insurance Plans

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• Preferred Provider Organization (PPO): This is a flexible healthcare plan where you pay lower rates for services performed by providers marked in your plan’s network. You still have coverage for “out-of-network” providers, but the costs are higher. This type of plan allows for a high degree of freedom in provider/ hospital choice but you may generally pay more for services.

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• Health Maintenance Organization (HMO): HMOs are generally area-specific insurance plans that limit covered services to doctors who work for or are contracted by the organization, with exceptions in emergency cases. These plans are generally very affordable and popular with patients who do not have significant health needs, as they are focused on preventative care and wellness.

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• Exclusive Provider Organization (EPO): EPOs are less flexible than a PPO, but more flexible than an HMO, is an EPO. This type of plan will only cover services from in-network providers, with an exception for emergencies. The advantage of an EPO is that patients will generally pay less for coverage and services.

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• Point of Service (POS): These plans incentivize patients to use in-network doctors, hospitals, and other health care providers. Patients pay less out of pocket when getting in-network care. Unlike with other health insurance plans, patients need a referral to have specialist visits covered.

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Government Subsidized Healthcare Plans

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You may have heard of two common government insurance programs called Medicare and Medicaid. These are government-sponsored health insurance plans for elderly/chronically ill and low-income patients, respectively. It’s important to note that you can generally choose between different insurance types like HMO, PPO, and EPO within the Medicare and Medicaid programs.

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The key difference is that they are government-sponsored rather than privately sponsored plans and patients can expect out-of-pocket expenses to be generally lower.Stuck on which healthcare insurance plan is best for you? Consult with a trusted healthcare provider and financial advisor to weigh your options — it’s important that whatever plan you choose addresses both your wellness and financial needs!

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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: 

“How to pick a health insurance plan.” Department of Health & Human Services.

“What are Medicare and Medicaid?” U.S. Centers for Medicare & Medicaid Services.