If you need to buy health insurance, you can choose from four basic types of policies. These policies vary in monthly cost, benefits, and deductible.
The Affordable Care Act
The Affordable Care Act (ACA, or “Obamacare”) made it impossible for health insurance companies to deny you health insurance due to an existing condition. Whatever your current state of health, you have the right to purchase health insurance. Depending on your age and your financial situation, you could be eligible for one of these types of health insurance:
- Medicare: If you are over 65 and have paid into the system over your years of employment, you are eligible for Medicare. Within the Medicare system, you have a range of choices. To select the plan that is most appropriate for your budget and health condition, it is advised that you get help from an insurance agent to explain the options.
- Medicaid: Low-income people and seniors, or people with disabilities may be eligible for Medicaid. These programs are managed at the state level and vary in cost, what the program is called, and how it is administered.
- Group Health Insurance: Many employers offer group health insurance to their employees as a benefit. About half of the people in the USA are covered through their work. You may have a choice of several different plans from your employer.
- Private Health Insurance: You can purchase your own health insurance policy if you are not covered through your work.
HMO, PPO, EPO, and POS: 4 Health Insurance Options
You have the choice of four basic types of health insurance, HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), EPO (Exclusive Provider Organization), and POS (Point of Service Plan). The basics of each type are as follows:
HMO
An HMO health insurance plan is typically lower in price and gives you access to the doctors and healthcare facilities within the HMO network. If you go to a medical provider outside the network, you will need to pay the cost of treatment out-of-pocket. However, the lower premiums make these plans very popular.
PPO
A PPO plan allows you to seek treatment from any medical provider you choose. The cost of treatment is lower if you access a medical professional within the plan network but pays for some of the cost of treatment out-of-network. If you have a doctor you want to continue to visit, find out his or her network before you buy, and choose accordingly. These plans are more expensive, and to reduce monthly premiums, you can choose a higher deductible.
EPO
An EPO health insurance plan allows you to see a specialist without a referral but must use the medical providers and hospitals in the plan’s network. These plans do not pay any of the costs of out-of-network treatments. The premiums for these plans are generally more than an HMO, but lower than a PPO.
Choosing the Right Plan
To understand your options in health insurance, one of our expert agents would be happy to assist you and help you choose the best plan for your budget, and that offers you the benefits you want most.