How To: Buy The Best Health Insurance Plan

Finding the right health insurance plan based on your requirements can be confusing. Should you opt for a plan with a lower deductible or low premiums? 

Listed below are the different types of health insurance plans. Explore these options to find the plan that best suits your needs:

Exclusive Provider Organization Plans (EPOs)

These insurance plans give you a network of providers that you can choose from, and provide no coverage for those providers that are not a part of the network. So, if you need to visit an out-of-network provider in a situation that isn’t an emergency, the visit will not be covered. Unless there is an emergency, it is recommended that you use the providers that are within the network so that you can be covered. 

Under EPO plans, you may also be responsible for coinsurance, deductible, and/or copayments.

Health Maintenance Organization Plans (HMOs)

Usually, HMOs have a network of providers with your insurance plan, and they need you to choose a primary provider or care physician.It is this primary provider who will look after all your healthcare needs. HMO plans have a limited network of providers and ask you to select a primary care provider so that they can keep the premiums and costs lower. Under this plan, if you need to consult a specialist, you’ll need to get a referral from your primary care provider before you can visit the specialist. HMO plans are extremely popular and have copays and deductibles for non-preventative care visits. Unless it is an emergency or prearranged by your primary care provider and approved by the insurance, HMOs usually prohibit you from seeing out-of-network providers.

High Deductible Health Plans (HDHPs)

A high deductible health plan is like a PPO, but with a higher deductible. These health insurance plans need you to pay the deductible before they provide you with coverage for services. However, HDHPs are also cheaper than other types of health insurance plans. 

Preferred Provider Organization Plans (PPOs)

PPOs also have a network of providers that you can consult, and these providers have pre-negotiated rates with your insurance plan. So this is how they manage to keep the costs down. You could also visit out-of-network providers, but you may need to pay a higher cost.

However, in PPOs, you can directly consult a specialist – you don’t need to get a referral from your primary care provider. For non-preventative care, you’ll have coinsurance or copays and an annual deductible. 

Point of Service Plans (POS)

These plans provide you with the flexibility that other plans lack. POS plans need you to choose a primary care provider that you visit to get referrals as well as for preventative care visits.

However, if you don’t mind paying the higher costs associated with their services, you can even consult out-of-network providers, instead of being limited to in-network providers only.