Working With Medical Insurance

Having health insurance can be a difference-maker, but finding a plan and making sense of the available options is oftentimes a challenge. If you're hunting for a health insurance plan, it can be helpful to have an understanding of what the different types offer. Let's take a look at six of the more common kinds of health insurance plans on the market today.

Health Maintenance Organization

HMOs tend to be tightly organized networks of hospitals, clinics, and practices. You usually have to deal with less paperwork when you're in your network, but going out of network often requires a referral and some evidence that you can't get the necessary care in the HMO's network. Emergencies out of network are usually covered at the in-network rate, though.

Preferred Provider Organization

PPOs represent the next rung up in terms of levels of freedom. You won't need a referral, but do expect to pay accelerated costs for going out of network. Customers can also expect to deal with more paperwork than with an HMO.

Executive Provider Organization

This is something of the in-between option that sits between HMOs and PPOs. There will be no coverage for going out of network, though, and you'll pay the full cost. EPOs generally have lower premiums than PPOs.

Point-of-Service Plan

The POS system is a little bit HMO and a little bit PPO. You can choose an out-of-network provider, but your primary care provider needs to coordinate your treatment.

Catastrophic Plan

These are limited plans that offer much lower premiums. Depending on the rules in your state, they may only be available to people under the age of 30. Preventative care is provided, but you'll only get three primary care provider visits before your deductible kicks in. Emergencies are covered, but expect to pay out of pocket for things like specialist visits. A cat plan may be better for someone who's young and has limited health issues.

High-Deductible Health Plans

HDHPs are usually modeled on PPOs, but they include a few different features. You can expect a significantly higher deductible, but you may also set up a health savings account to prepare for paying the extra out-of-pocket expenses. Notably, HSAs are not taxed and can be used tax-free when paying for medical expenses.

Anticipate keeping close track of expenses with HSAs and HDHPs. You'll want to keep all receipts when you pay medical bills, and it's critical to know when you've met your deductible.