When do I need health insurance?
If you are not covered as a dependent on someone else’s health insurance plan, such as a spouse/partner or parent, it is a good idea to purchase health insurance. The cost of health care without insurance can be high.
What are the different types of health insurance? Different types of health insurance include:
Health Maintenance Organizations (HMOs)
Product Supplier Organization (EPO)
Proposition of Operations (POS).
Approved Supplier Organizations (PPOs).
Not sure what type of health insurance is right for you? Here is a detailed description of each type of health insurance plan. What are Health Maintenance Organizations (HMOs)?
HMOs provide you with a local network of doctors, hospitals and health professionals and facilities to choose from. These types of health insurance plans also require you to choose an in-network primary care provider (PCP). Your PCP is your go-to place for health care. They know you and coordinate all your care. They will also want to give you referrals to network professionals. The costs of HMO plans – copays and coinsurance – are usually lower than those of other types of health plans, as long as you stay in network.
What are Product Provider Organizations (EPOs)? EPO gives you a network of service providers to choose from. Most EPO plans do not include coverage for out-of-network care except in emergencies. This means that if you go to a provider or company outside of the plan’s local network, you will have to pay for the service yourself.
Depending on the plan, you may or may not be required to choose a primary care provider (PCP). If you want to see a specialist in your network, you don’t need a referral from a PCP.
What is Point of Service (POS)?
POS plans combine HMO and PPO plans. Networks of providers are often smaller than PPO plans and fees for in-network care are often lower, such as HMOs. POS plans also require you to choose a primary care provider (PCP) from a network of doctors and other primary care specialists. Your PCP is your go-to place for care and advice. They get to know you and your health needs and can help coordinate all of your care. If you want to see a professional, you will get a referral. However, like a PPO, you can also choose to see in-network or out-of-network specialists. If you see a doctor outside of the plan’s network, your share of the cost will be higher and you will be responsible for the claim yourself.
What is a Preferred Provider Organization (PPO)? PPOs often provide you with a large network of participating providers, allowing you to choose from a large number of doctors, hospitals and other healthcare professionals and facilities. You can also choose to see providers outside the plan’s network, but you’ll pay more out of pocket. Choosing a primary care provider (PCP) is not mandatory with these types of health plans, but you may find specialists without a referral.
What type of health insurance is best for me? Start by understanding your specific health care needs:
If you’re in good health and don’t see a doctor often, health insurance plans with high deductibles often have lower deductibles and can help you save money.
If you need or expect more preventive care, consider plans with lower deductibles and coinsurance, for other unexpected costs. I have a chronic illness. What type of health insurance is best for me? Chronic illness may require regular medication and medical appointments, and even hospital stays and/or surgery. Consider a health plan that helps reduce out-of-pocket expenses based on what you plan for health care, specialist visits, prescription drugs, etc. A little planning time will help you choose the right type of health insurance.