Types of health insurance plans available in country

Types of health insurance plans available in country

When it comes to getting a health insurance quote online or narrowing down on a health insurance policy that suits your specific requirements and fits into your budget, it is important to be cognizant of the different types of health insurance plans available in the country.

Health insurance plans fall under the following categories:

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Exclusive Provider Organization (EPO)
  • Point of Service Plan
  • Catastrophic Plan
  • High Deductible Health Plan

An HMO plan requires you to avail of health care services only through a specified network of medical professionals, thus greatly limiting your choice of doctors. You would require a primary care physician to refer you to a specialist if necessary.

Under the PPO plan, the flexibility with regard to the choice of medical professional is more. If you consult with a doctor who is not in the network, then your costs would be higher.

Under an EPO plan, there would be no option of consulting a doctor who is out of the network; as such, a physician’s costs will not be covered under the health insurance policy. However, you do not need a primary care physician’s referral.

A Point of Service Plan covers the HMO and PPO plans, giving you a moderate degree of flexibility with regard to choice of doctor. You would be assigned to the care of a primary care physician who could refer you to an in-network practitioner, in which case, costs would be covered. You could consult an out of network doctor but have to pay those costs out of pocket.

A catastrophic health insurance plan can be applied for if you are under the age of 30, which comes with a lower premium and requires a minimum of three visits to the primary physician before the deductibles will apply.

The advantage of the Highly Deductible Health Plan with Health Savings Account is that you can put aside money at intervals into this account to pay for your health care needs so that when the policy does not cover your expense, you have this savings account to fall back upon.

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