Captain Health USA

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Understanding the Different Health Insurance Options Available To You

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When it comes time to select an insurance plan, which will you choose?  An HMO? PPO? EPO?  What do the acronyms mean and what are the differences?  This blog article will give you clear, concise understanding so you can make an informed decision when it comes time to choose or change your healthcare plan.

HMOs:  Health Maintenance Organization Plans

yocg-wednesday-10-26-16-canvaThis plan centers around a Primary Care Physician or a PCP.  Essentially, your PCP manages and coordinates your healthcare, referring you to specialists and hospitals within a designated network.  It is important to note that only those in-network services referred by your PCP will be covered by the plan.

PPOs:  Preferred Provider Organization Plans

PPO plans allow you and your family to receive care from any health care provider they choose within the insurance company’s network.  This list of providers can include specialists.  The major difference with a PPO is that a referral from your primary care physician or PCP is not required.  This type of plan is generally preferred by those individuals who tend to se a specialist on a regular basis.

EPOs:  Exclusive Provider Organization

This type of plan gives you access to all the providers and specialists within the EPO network.  EPO plans usually do not offer coverage outside of the network unless it is an emergency.  

POS:  Point of Service Plans:

This plan acts as a hybrid between the HMO and PPO.  In this type of plan, you usually select a primary care doctor for routine visits such as check ups as well as for specialist referrals.  The difference is, you are permitted to utilize providers outside of the network, but, you can expect your out-of-pocket expenses to be hight.  Additionally, you will be subject to copays and deductibles.  This type of plan works well for those who like the extra flexibility and who are willing to pay a little be more.

HDHP:  High Deductible Health Plan

yocg-thursday-10-20-16-canvaThis type of insurance plan has high deductibles which you must meet before the health insurance coverage actually goes into effect.  People attracted to this type of plan are those who want to save money on the monthly premiums.  These are also people who don’t intend on using their medical coverage as often as others.

This type of plan may also be used with a Health Savings Account or an HSA where the individual contributes to the account on a pre-tax basis allowing them to pay for healthcare expenses and deductibles.

Now that you are aware of the various plans available to you during open enrollment, you can make an informed decision.

Still have questions or concerns?  Contact me today!  I can be reached at (813) 391-3448 or Email me at Dave@YourObamacareGuy.com

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