health insurance

Different Types of Private Health Insurance Plans

An insurance plan can assist you in managing your health care needs and costs. Health care costs without insurance coverage can be substantial. According to the U.S Census Bureau, most Americans are enrolled in a private insurance plan. Others are covered by federal programs like Medicaid or Medicare.

Choosing an insurance plan that suits your needs and financial status is extremely important and can be overwhelming. Private health insurance is any health coverage provided by a private company rather than the federal government. The following are the types of private Health Insurance (2022) plans.

Health Maintenance Organization (HMO)

These are the most common types of health insurance plans. They offer an entire local network of health care providers like hospitals, doctors, and other facilities to choose from. In addition, you pick a PCP (primary care provider) to coordinate your medical care. HMOs, cater to most preventive care, including specialist visits upon referral by your PCP.

However, you pay for the non-preventive medical visit and a yearly deductible amount. HMOs are the best option for people or families that regularly visit their primary care doctor for check-ups and other health issues. What’s more, as long as you stay in the network, the cost of HMOs is lower than other health insurance plans. Private health insurance reports a significant increase in HMO plans since 2014.

Preferred Provider Organization (PPO) Plans

With this plan, you and your dependents can visit any health care provider in your network without a referral. In addition, you don’t have to choose a PCP. PPOs offer a large network of doctors, hospitals, and other medical facilities to pick from. Over and above that, you may choose a provider outside your insurance network, but you will bear the full cost. Further, you will have copayments for non-preventive medical care and an annual deductible.

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Exclusive Provider Organizations (EPOs)

They are similar to HMOs since they have a network of doctors that their members should use except in case of emergencies. However, it comes with some freedom as you don’t have to get a referral from your main doctor to visit a specialist. The plan doesn’t cater to the cost of seeing another provider outside your network. This means that you pay the full cost of the services yourself.

Point Of Service (POS)

This is a blend of HMO and PPO plan features. You choose a PCP to regulate your regular check-ups and referrals. Nonetheless, like with a PPO, you can visit a specialist out of your insurance network, but you share costs. Besides, your cost share will be higher, and you have to file claims yourself. POS is a versatile plant that’s ideal for individuals willing to pay a little for their flexibility.

Indemnity Plans

This is also known as a fee-for-service plan. It allows you to choose your specialist or doctor. Private health insurance indicates that indemnity plans have the most expensive rates. Having freedom in the choice of your health care providers boosts your primary health care.

The type of insurance plan dictates how you will approach the medical provider when looking for health care, and the cost you will have to pay for the service.

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