• Kirk Ellis

Different Types of Health Insurance

The one-size-fits-all approach just doesn't cut it when it comes to health insurance plans. There are benefits and disadvantages to every type of health insurance plan. Finding the right health plan will take plenty of research. However, researching your next health insurance plan with the knowledge of the different types of health insurance can make the process far more painless.


Below, Trusted Referral Network has outlined everything you need to know about the various types of health insurance coverage –– including the benefits and limitations of each –– to ensure you select the right plan for you and your organization.


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Types of Health Insurance Plans

  1. Preferred Provider Organization (PPO)

  2. Point of Service (POS)

  3. Health Maintenance Organization (HMO)

  4. Exclusive Provider Organization (EPO)


Preferred Provider Organizations (PPO)


Preferred Provider Organizations are plans where employees receive incentives to use a preferred network of hospitals and health care professionals. Under a Preferred Provider Organization plan, employees must meet an annual deductible. They may be responsible for a percentage of total charges –– making this a more costly plan in exchange for a more extensive network of health care providers. Employees can still use out-of-network doctors and hospitals but will pay more money out-of-pocket as they will not receive the discounts they would with a preferred provider.


Point of Service (POS)


Point of Service plans differ from Preferred Provider Organizations in that employees must get a referral from their primary care provider for specialist visits. In contrast, under a PPO an employee does not need a referral to visit an in-network specialist. Unlike a PPO plan, employees under a POS plan may be required to choose a primary care physician (PCP) from the plan's provider network. Should an employee receive services or a referral from their primary care doctor, they will receive a lower rate than they would for an out-of-network provider.


Health Maintenance Organizations (HMO)


HMO plans are generally focused on preventive care and wellness and are one of the more limited health insurance plans on this list. Health Maintenance Organization plans do not generally cover out-of-network care (except in rare emergencies) and limit coverage to a provider network of professionals who contract directly with the HMO. An advantage of HMO plans is that out-of-pocket medical expenses are generally lower, which is a benefit some might be willing to sacrifice broader coverage for.


Exclusive Provider Organizations (EPO)


Similar to HMO health plans, human services under an Exclusive Provider Organization plan are only covered when individuals use doctors and hospitals in the plan's network. Members of an EPO must have a primary care doctor who will provide referrals when necessary, and individuals on this plan will be responsible for co-payments –– and potential deductibles. This health plan trades a limited network for lower overall medical costs, making it the right choice for some.


Make the Right Choice with Trusted Referral Network


If you still don't know which of these health plans is right for you, you're not alone. Trusted Referral Network can help match you with the right health services plan to match your specific needs –– ensuring you get the medical care you deserve at a price that fits your budget.


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References: 1. https://www.healthcare.gov/choose-a-plan/plan-types


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