Individual vs Family Health Insurance

How do you know which type of plan is most suitable for you and your family members?

The Different Types of Health Insurance Plans

There are four main types of health insurance plans: Preferred Provider Organizations (PPOs), Health Maintenance Organizations (HMOs), Point-of-Service (POS) plans, and Exclusive Provider Organizations (EPOs). 

PPOs, HMOs, and POSs are all managed care plans. EPOs are similar to PPOs, but they don’t have out-of-network coverage. 

Continue reading to learn more about the various types of health insurance plans and to get some help deciding which one might be the best option for you and the members of your family.

Preferred Provider Organizations (PPOs)

If you have a PPO plan, you do not need a referral from your primary care physician in order to see a specialist or other type of doctor who is part of the network.

You can also go outside of the network, but the services you receive will be more expensive if you do so. The monthly premiums for PPO plans are typically higher, but the out-of-pocket costs are typically lower.

Health Maintenance Organizations (HMOs)

You are required to select a primary care physician from within the HMO’s network if you are enrolled in an HMO plan. When it is appropriate, your primary care physician will make referrals to specialists who are part of the network.

Except in critical circumstances, you won’t be able to leave the network under any circumstances. The monthly premiums for HMO plans are typically lower, but the out-of-pocket costs are typically higher.

Point-of-Service (POS) Plans

Plans that fall into the POS category combine elements of PPO and HMO insurance. You select a primary care physician from among those who are part of the network if you have a POS plan.

You can also get services from providers that are not part of the network, but doing so will result in higher overall costs. The monthly premiums for POS plans are typically higher, but the out-of-pocket expenses are typically lower.

Exclusive Provider Organizations (EPOs)

An EPO is similar to a PPO in that you can visit any doctor or specialist within the network without a referral from your primary care doctor. 

However, if you have an EPO plan, you will not be covered if you go to a provider that is not in your network. The monthly premiums for EPO plans are typically higher than those for PPO plans, but the out-of-pocket costs for EPO plans are typically lower than those for PPO plans.

Now that you know more about the different types of health insurance plans that are available…

Now that you know more about the different types of health insurance plans that are available, it’s time to start thinking about which one might be right for you and your family members. 

Consider factors such as whether you want comprehensive coverage or just basic coverage, how much you’re willing to pay in premiums, and whether or not you want the flexibility to see doctors outside of your insurance network. 

When you’ve given careful consideration to all of these aspects, you’ll be one step closer to selecting a health insurance policy that’s ideal for you and your family’s needs!