Understanding Types of Health Insurance


Shopping for insurance plans is like trying to choose among piping hot bowls of alphabet soup. With names like HMO, PPO, HSA, and HDHP, how do you know which type is best for you? By learning about your different plan options, knowledge makes the alphabet soup of health insurance plans go down smoothly when you make the right choice for you.

HMO (Health Maintenance Organization) Plans

HMO, or Health Maintenance Organizations Plans, cover care provided by hospitals and doctors inside their own network. Seeing a specialist requires a referral from a primary care provider. If you want to see a doctor outside the network, you’re typically responsible for the entire bill. You may be required to pay a deductible amount before it covers care beyond preventive services, but you will not have any claim paperwork. If the idea of one primary care provider coordinating all your care with little out-of-pocket expenses for in-network providers, a HMO might seem the most attractive choice.

PPO (Preferred Provider Organization) Plans

PPO plans give a bit more flexibility when choosing your health care provider and typically pay a higher percentage of the cost for out-of-network care. You can see a specialist without a referral required, but you may be doing more paperwork for claims if you choose an out-of-network provider. If you visit a specialist regularly, a PPO might work well for your needs.

POS (Point-of-Service) Plans

A mix between a PPO and HMO, a Point-of-Service (POS) Plan offer more flexibility and some out-of-network coverage. You still select a primary care provider who issues specialist referrals, but you have access to seek out-of-network coverage. If you don’t mind paying a bit more for the flexibility to see providers, a POS might be a good choice.

HDHP with or without HSA

A high deductible health plan with or without a health savings account means you handle all health care costs until you meet a certain amount: your deductible. After you meet your deductible, you pay a percentage of medical costs until you reach an out-of-pocket maximum. Some plans set up a health savings account (HSA), which is where part of your pre-taxed income is set aside to use for your deductible. High deductible health plans with HSAs can be great choices for people who do not anticipate going to the doctor frequently and are relatively healthy.

Osborne Insurance Services Can Help You Decode Insurance Alphabet Soup

You don’t have to struggle to make sense of the health insurance alphabet soup on your own. A knowledgeable insurance broker can help you navigate through the plan types to give you a range of options.

Since 1997, Osborne Insurance Services has helped thousands of Tar Heels find and maintain health insurance plans to fit their needs. We work hard to be your trusted advocate and dedicate ourselves to providing the best customer service to serve as more than just health insurance agents.

Contact us today so we may assist you in selecting the right type of health insurance that meets your needs.

Tags: Obamacare, Open Enrollment Period