A Guide to the Different Types of Health Insurance Plans

From the years 2017 to 2018, the number of uninsured people increased by almost half a million.

This comes out to 27.9 million  non elderly individuals who lack health insurance in this country.

Frankly, that number is far too high. One health emergency, such as a broken arm or an unexpected surgery, could send people into medical debt.

Nearly 79 million Americans have medical debt or medical bills they’re struggling to pay. Many of those Americans are either uninsured or under-insured.

That being said, what are the various types of health insurance plans? If you’re currently uninsured, or you are insured but wondering about your policy’s guidelines, you’re in the right place.

Knowing as much as you can about your plan can give you the confidence to choose wisely and within your budget. Let’s get started.

PPO

PPO, or Preferred Provider Organization, is the most comprehensive health insurance policy. It has the largest network of healthcare doctors, facilities, and specialists under its umbrella.

Of course, this fantastic coverage does come with a higher price tag—making it the most expensive of the various healthcare plans.

With PPO plans, you can see any specialist you need to without having to consult with a primary care physician first. There are also fewer restrictions when it comes to seeing out-of-network providers.

This type of plan is generally preferable for anyone who needs to see a specialist regularly.

HMO

HMO, or Health Maintenance Organization, is a more inexpensive type of health insurance plan. HMO plans are known for being more affordable than PPO plans—premiums are usually lower—but it does come with some restrictions.

For example, the network of doctors you can see is smaller in an HMO plan, and to see a specialist, you’d have to first get a referral from a PCP, or primary care physician. This second opinion from a specific PCP is a way for HMOs to contain their costs.

HMO policies typically also have lower out-of-pocket costs. Your deductible may be small, or even non-existent.

However, if you see a doctor outside of your network, you can expect to pay 100% of the costs.

EPO

And finally, EPO stands for Exclusive Provider Organization. This plan is like a combination of the above two plans.

Those insured through EPO healthcare plans can visit any provider within the EPO network. Most often, they don’t need to consult with a PCP first before seeing specialists.

However, if a member of this plan were to see someone outside of the EPO network, then—like HMO plans—they can expect to pay for it out-of-pocket, possibly even 100% of the costs.

Which of These Types of Health Insurance Plans Will You Choose?

As you can see, you have options when it comes to your policy.

You don’t have to splurge for something that’s outside your budget or settle for less when you can afford more. These types of health insurance plans allow for a variety of people to enroll.

We can help—whether you’re paying too much for your current plan, you need to stay with a specific doctor or specialist, or you have a qualifying event outside of open enrollment. We offer individual and family health insurance, as well as accept those with pre-existing health conditions. We even have short-term or travel insurance!

We provide it all. Contact us today at Just Us Insurance, Inc. We’ve been helping Southern Californians find affordable coverage for over 15 years.