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Service with a fee.~Plans bought through Preferred Provider Organizations, Health Maintenance Organization, Exclusive Provider Organization, Point of service, and Fee for service are the five basic types of health insurance plans.~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.~There are five general types of health insurance. HMOs, PPOs, EPOs, point of service, and service for fee.}

Health insurance plans can be divided in five core categories. They differ from each other by offering divergent coverage and limitations. To find the best health insurance plan for their clients, health insurance agents are allowed to use health insurance leads. 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. Most Americans buy their insurance through an HMO because that’s the way most employers do it. HMOs are the most affordable type of insurance plan and may include preventive care, dental care, and eye care in its coverage. HMOs provide their policyholders with a broad network of doctors, specialists and healthcare facilities. A primary-care physician works as a gatekeeper and is selected by policyholders to direct all healthcare services and medical needs when needed. An HMO covers expenses only when the patient’s primary care doctor refers him or her to a medical service or a specialist. The downside of an HMO plan is that it is the most restrictive type of healthcare plan. Sometimes a plan requires that the patient pay a co-pay when visiting a doctor.

Preferred Provider Organizations (PPOs)

Being different from HMOs, PPOs do not require a referral from your primary care physician. But, cost-wise it is advantageous if the healthcare services and specialists chosen by the policyholder are within the PPO’s own prescribed network. It would require the insured to pay 20% of the total costs while the remaining 80% is covered by the PPO, for services and facilities sourced from outside the network, and are more expensive.

Exclusive Provider Organization (EPO)

Exclusive Provider Organizations, or EPOs, are nearly similar to PPOs, however have 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)

Health insurance plans which fall under a point of service type is similar to PPOs since they also have a primary-care physician. These will allow the insured to go to specialists at their own discretion.

Fee for service (FFS)

The type of health insurance plan that is least restrictive and offers a wider range of choices of medical specialists and facilities is the Fee for services. To choose which doctor, facility or treatment they want, fee for service policyholders are given this discretion. The insured has to pay a preset deductible amount, before the insurance provider gives money for these services. Even when insured you will have to pay 20% out of your pocket for every service. A maximum amount that the insured is required to pay is stipulated in the insurance contract.

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, always complete a thorough assessment of your own healthcare needs and financial capacity.

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