The Main Types of Private Health Insurance
When looking for a health insurance plan, you need to consider many factors. Your pre-existing conditions, your dependents, and your budget among others will all determine the best plan for you.
When considering different health insurance companies and different insurance plans, it is essential to do thorough research and get a quote from each company on each plan you are considering.
The price that you’ll find online or the price that someone else pays is not necessarily what you will pay for the plan.
Although plans differ from company to company, there are certain types of plans that are largely the same, regardless of which company you choose. The main types of private health insurance plans are outlined below.
HMO stands for Health Maintenance Organization. Getting HMO health insurance lets you access lower-cost payments compared to other private healthcare plans.
Before settling on this plan, prepare for three types of payments: premiums, deductibles, and copays.
Premium is the amount you pay monthly. Before covering care, the plan may require you to pay a certain amount (deductible) except for preventive care. Once you get the care, the plan will require you to pay a flat fee (copay) of approximately $15.
This plan enables you to choose a primary health provider among the given options. The provider guides you and provides a referral when you need the services of a specialist.
Besides the limited choice of service providers, you have to pay the full deductible.
As an advantage, the HMO health insurance doesn’t require paperwork (filling claim forms).
Also, they are one of the cost-friendly insurance plans in the market. If you seek medical services out of your insurance network, you pay rates similar to those of in-network insurance services.
POS stands for Point of Service. If you want more freedom of choice than HMOs, a POS can be an excellent option. POSs allow you to select a larger variety of healthcare providers.
Your primary care doctor lets you seek specialist services from a myriad of providers within your network. However, there is a catch:
If you seek medical assistance out of your insurance network, you will pay more. And you should prepare for more paperwork with POS health insurance.
If you receive healthcare services outside your network, you can submit a claim to the plan provider for the POS and they may refund your expenditure outside their network.
Are you aged 30 years or less? Then, Catastrophic health insurance may be a good option for you. Unlike other managed health insurance plans, they present you with the lowest premiums.
Before you start paying deductibles, you must have attended 3 care visits. With catastrophic insurance plans, you have access to free preventive care. You pay an average of 8150 USD, on an individual and 16,300 USD for a couple, for a deductible.
A Health Savings Account is an employee or a small business-owned insurance plan. As an employee or a small business enterprise, the IRS allows you to make pre-tax contributions to your insurance plan.
If you don’t use certain funds in your savings account, the IRS rolls it over for the following financial year. Then, the funds accrue interest. Better yet, the government doesn’t tax the accrued interest.
PPO and EPO
PPO stands for Preferred Provider Organization while EPO is the acronym of the Exclusive Provider Organization. They do not require you to have a primary care doctor.
On average, you pay $200 for a physical checkup, $125 for a physical therapist, $500 for MRI, and $170 for Ultrasound-Fetal. There are slight differences between PPO and EPO. These are:
If you seek medical services outside of your insurance network, you pay more with both EPO. EPO extends further to drop the full treatment costs on you. there is more paperwork with PPO whereas EPO has little or no paperwork.