Types of Health Insurance Plan

When you browse for health insurance, you must be noticed that actually there are few types of health insurance plan. Understanding the difference between these plans is important lest you’ll choose the insurance plan that cannot fulfill your health care needs. So, this time we are going to tell you about the types of health insurance plan with their summary details. Have a look. (Related Article: Learn about Health Insurance Terminologies and Plans)

Health Maintenance Organization (HMO)

HMO plan will cover all health care costs, but only if you see doctors in HMO networks or providers. This means you don’t have freedom to choose health care providers. If you see out-of-network doctors, the insurers won’t help you paying the cost unless you go to them for emergency reason. What you have to pay:

• Premium, this is a set fee you have to pay per month for insurance plan.
• Deductible, the amount you have to meet before the insurers can cover the health care you need.
• Copay, the amount you have to pay when you get certain care. It is usually flat fee for HMO plan around $15.
• Coinsurance, the percent amount you have to pay for medical expenses and the remaining percent will be paid by the insurer. It is varied for each plan, but usually it depends of the amount of your deductible.

You don’t need to do paperwork or make claim, since the insurers would 100% cover your medical expenses.

Preferred Provider Organization (PPO)

PPO plan allows you to see doctors outside PPO networks or providers, but you may have to pay more for that. You also can see specialist without getting referral from the primary care doctor.

What you have to pay:

• Premium, a set fee you have to pay per month.
• Deductible. It requires you to pay higher deductible if you prefer to see out-of-network health care service.
• Copay, a certain fee you have to pay after receiving care. It is usually $15 and it is flat fee.
• Coinsurance, the percent amount you have to pay for medical expenses and the remaining percent will be paid by the insurer. It is varied for each types of health insurance plan, but usually it depends of the amount of your deductible.

You don’t need paperwork for in-network doctors. If you see out-of-network doctors, you have to pay by your own pocket first. Then file the claim so the insurer can reimburse your money.

Point-of-Service Plan (POS)

Basically, POS plan is the combination between HMO and PPO plan. In POS plan you can see specialist that referred by your primary care doctor and you are allowed to see out-of-network providers though you have to pay it more.

What you have to pay:

• Premium
• Deductible. Higher amount if you’d like to see out-of-network doctors.
• Copay.
• Coinsurance.

You need to file claim so the insurer can reimburse your money.

Catastrophic Plan

Catastrophic plan have few benefits like lower premium than the other plans and free charge of the first three visiting times to primary care and preventive care even if you have not reached your deductible.

What you have to pay:

• Premium
• Deductible. This types of health insurance plan will cover all your medical expenses after you completed the deductible.