When you are a generally healthy adult without any ongoing health conditions, you have a lot of options when it comes to health insurance. Since you're a low-risk individual, almost any health insurance company is going to be happy to insure you, and probably for an affordable rate. So, how do you know which type of insurance policy is best? Read on for a look at each of the four most common kinds of healthcare plans—and the pros and cons of each one.
HMO: Health Maintenance Organizations
When you are insured through an HMO, you can only be treated by providers in the HMO's network. You'll have a primary care doctor within the network, and he or she will be responsible for referring you to specialists within the network if you need to see a specialist. If you want to see a doctor who is not a member of your HMO, the insurance plan won't cover it; you'll need to pay for the visit yourself.
HMO-type plans tend to be very affordable for healthy people. Some plans require you to pay a deductible before the insurance starts covering certain types of costs, such as emergency costs or specialist visits. The primary benefit to this type of plan is that you don't have to file claims or worry about submitting a lot of paperwork. The downfall is that you can only see certain doctors.
PPO: Preferred Provider Organizations
When you have insurance through a PPO, you can seek treatment by any doctor in the PPO network, but you can also see doctors outside of the network; you'll just have to pay more out of pocket. Most PPOs are less referral-based than HMOs. If you want to see a specialist, you just arrange to see one—your primary care doctor does not have to refer you.
If you want more control over your healthcare and the providers you choose, then a PPO may be the right choice for you. However, you will have to file claims if you see a doctor outside the PPO network. PPOs tend to be more expensive than HMOs, but if you are a healthy adult, the difference in cost should be negligible.
EPO: Exclusive Provider Organizations
EPOs share some similarities with both PPOs and HMOs. This type of plan requires you to see only in-network doctors. If you want to see someone outside of the network, you have to pay out of pocket, just like you would with HMO-type insurance. However, as with a PPO, you do not need referrals. You can see any in-network specialist you want as long as they are in the network.
A benefit to choosing an EPO is that there is very little paperwork involved. Premiums tend to be lower than with a PPO or HMO. However, if there are not a lot of providers in the network in your local area, you may have to drive quite far to get treatment.
If you are a young and healthy adult on a limited budget, you may want to enroll in a type of healthcare coverage called catastrophic insurance. Basically, this type of insurance has a high deductible. You pay for all of your health costs up to that deductible, and the plan kicks in and pays for any costs after that. Basically, you are insured in the case of a huge catastrophe that would land you in the hospital, but if you just see the doctor a few times per year, you'll end up paying for that out of pocket until the deductible is met.
To learn more about these types of health plans, reach out to an insurance agent in your area, or check out websites like healthyppo.com.Share