5 Basic Types Of Health Insurance Plans Everyone Needs To Understand

Insurance bought through a Health Maintenance Organization, Preferred Provider Organizations, Exclusive Provider Organization, Point of service and Fee for Service are the 5 basic types of health insurance plans.

Health insurance plans can be divided in five core categories. They differ from each other by offering divergent coverage and limitations. Health insurance agents may use Health Insurance Leads to determine what type of health insurance plan is suitable to a customer. But, as a smart insurance buyer, you need to do your part and understand what the types are before making a decision.

Health Maintenance Organization (HMO)

A Health Maintenance Organization is one of the most common types of health insurance. The majority of American employees purchase their insurance through an HMO because this is typically what their employers offer them. Choosing an HMO is easier on your wallet and offer a variety of coverage. A broad network of doctors, specialists and healthcare facilities are provided to the policyholders of HMO. Policyholders decide on a primary-care physician who will guide all healthcare services and medical needs necessary. The physician is sort of like a gatekeeper in this aspect. HMOs will only cover expenses when the primary-care physical refers the patient to the specialist or medical service. One of the disadvantages of an HMO plan is that, of healthcare plans, it is definitely the most restrictive. Depending on the plan stipulations, a co-pay may be needed in order for the patient to visit a doctor.

Preferred Provider Organizations (PPOs)

A PPO does not require you to get referrals. You should know that it is cheaper if you pick the health care providers and services that are listed as being within your own PPO's network. PPOs may only pay 80% for any medical care received from providers who are not among their recommendations, since such care could cost more, so any PPO clients should be aware they may pay 20% of the bill from outside sources.

Exclusive Provider Organization (EPO)

Exclusive Provider Organizations, or EPOs, are somewhat similar to PPOs, but has a distinctly smaller network. EPOs are not similar to PPOs because the former do not provide insurance cover for the services rendered by those specialists which are not listed in their own network.

Point of service (POS)

Point of service plans are similar to PPOs because you are given a primary care doctor. They also let the insured to seek services from healthcare specialists outside its own network, however, is more expensive and needs additional paperwork to be complied.

Fee for service (FFS)

Fee for services is the least restrictive type of health insurance plan and offers a wider range of choices of medical specialists and facilities. Fee for service policyholders are given the discretion to choose which doctor, facility or treatment they want. The insured has to pay a preset deductible amount, before the insurance provider gives money for these services. The insured is also normally required to pay 20% of the costs for every service he or she accrues. The insurance contract stipulates a maximum amount of monies which must be paid out by the insured.

Always complete a thorough assessment of your own healthcare needs and financial capacity when choosing a health insurance plan so you can get the most out of the advantages the one you select offers and offset the disadvantages.


Additional details about Health Insurance Leads can be found at http://www.toppickleads.com/health_insurance_leads.html.