Health insurance is one of the things that can save you and your family a great deal. Without health insurance, you are likely to receive less medical care. You can buy health insurance from either an insurance broker or the states marketplace. Either way, you will have to choose from one of the four levels of insurance; platinum, gold, silver or bronze. Platinum offers the most coverage while bronze offers the least. People under 30 are also able to buy a catastrophic plan which is a high-deductible health insurance level. Here is a breakdown of how much each of the levels cover
Bronze - you pay 40% of the medical cost and the insurance takes care of the remaining 60%
Silver - you pay 30% of the medical cost and the insurance takes care of the remaining 70%
Gold - you pay 20% of the medical cost and the insurance takes care of the remaining 80%
Platinum - you pay 10% of the medical cost and the insurance takes care of the remaining 90%
Every insurance brand may associate itself with the discussed levels. The following are the common types of health insurance plans offered by insurance brands.
1. Health maintenance organizations (HMOs)
HMO is a very popular health insurance plan making it ideal for purchase. When you purchase this type of health insurance, you will be required to select a primary care provider to coordinate your health care and services. However, all health care providers can offer you its services.
HMOs covers a wider range of preventive care inclusive of specialist visit. However, the specialist visit has to be recommended by your Primary care provider. HMOs are the most suitable plans for families and individuals planning to visit their primary care providers on regularly for checkups.
This health insurance plan does not have claims forms to fill out
2. Preferred provider organization (PPOs)
Under this health insurance plan, the holder and their family can visit any health provider in the network of the insurance company including specialist. Unlike HMOs, PPOs do not require referral by the primary care providers to see a specialist. You will have copayments for all non-preventive care given and may have annual deductions. The plan is ideal for individuals who require or prefer regular visits to a specialist.
If you see a specialist outside the network of the insurance company, you will have to pay the specialist and then file a claim so that your plan can pay you back.
3. Exclusive provider organizations (EPOs)
With this plan, you can get the services of any health care provider enlisted in the network of your insurance company, including specialists. As seen above, PPOs have an opening to cover for health care received outside the company’s network. With EPOs, such arrangements are typically not allowed unless it is an emergency. The plan is suitable if the insurance holder dos not mind being confined to health providers within a certain network and do not require coordination by primary care doctors.
4. Point of service (POS) plan
POS health plan is cross bred between PPOs and HMOs. With this plan, you will be required to delegate a primary care doctor for referrals and regular checkups in the network of your insurance company. However, if you are comfortable with paying more out the pocket, you are free to visit providers outside the network. It is usually accompanied with deductibles and copayments. The plan is clearly versatile and suitable for people who want more flexibility and do not mind the extra cost.
5. High Deductible Health Plans (HDHPs)
This plans are cross categories under which some plans are PPO while other HMO or EPO. Before this health care plan takes effect, the holder has to meet high deductibles. The plan is very effective for people who do not have plans to extensively use their medical cover as well as save money on monthly premiums. More often, the HDHPs are tied to Health Savings Account (HSA) such that if you contribute funds to HSA, you are able to purchase a HSA-compatible medical plan. The funds given to HSA can be saved on tax deductible or pre-tax basis then used to pay for medical expenses inclusive of annual deductibles.