These four types of health plans can help you find the best insurance
(1). HMO
HMO stands for “Health Maintenance Organization.” HMO plans offer a wide
range of health care services through a network of providers that contract with the
HMO, or who agree to provide services to members. Members of HMO plans will
typically need to select a primary care physician (“PCP”) to provide most of their
health care and refer them on to HMO specialists as needed. Health care services
obtained outside of the HMO are typically not covered, except in an emergency
An HMO plan may be right for you if,
• You’re willing to play by the rules and coordinate your care through a primary
care physician
• You want to save every dollar possible; many HMO plans typically have lower
monthly premiums than comparable
(2). PPO
PPO stands for “Preferred Provider Organization.” Like the name implies, persons
covered under a PPO plan generally need to get their medical care from doctors or
hospitals on the insurance company’s list of preferred providers in order for claims to
be paid at the highest level. It’s your responsibility to make sure that the health care
providers you visit participate in the PPO. Services rendered by out-of-network
providers may not be covered or may be paid at a lower level.
A PPO plan may be right for you if,
• Your favorite doctor already participates in the network; you can sort for plans
accepted by your doctor after getting quotes at eHealth.com
• You want some freedom to direct your own health care but don’t mind working
within a list of preferred providers
(3). EPO
EPO stands for “Exclusive Provider Organization.” EPO plans are similar to PPO
plans but may be somewhat more restrictive when it comes to your network of
doctors and hospitals. EPO plans typically do not provide you with coverage
outside your network, except in emergencies. EPO plans are becoming more
popular with health insurance shoppers, and health insurance companies are
offering more of them as well. You’re generally not required to select a single
primary care doctor with an EPO plan.
An EPO plan may be right for you if
• You don’t mind getting your care through a specific network of doctors and
medical providers
• You prefer not to coordinate your medical care through a primary care doctor
(4). HSA
HSA plans are usually PPO plans with higher deductibles, designed
especially for use with Health Savings Accounts (“HSAs”). Similar to a flexible
spending account (FSA) or 401(k), an HSA is a special bank account that allows
participants to save money –pre-tax– to be used specifically for medical expenses
in the future. Unlike FSAs, the money in an HSA rolls over every year and can also
earn interest. By pairing a qualifying high-deductible health plan with an HSA,
participants can save money on health care and earn a tax write-off. Find more
information about HSAs online at www.eHealth.com/hsa.
An HSA-eligible plan may be right for you if
• You would like to pay for health care expenses with pre-tax dollars (up to an
annual limit)
• You’re relatively young and healthy and don’t often visit the doctor
• You prefer a cheaper monthly premium even if it means having a higher
deductible in case of unexpected injury or illness
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