When you shop for health insurance, you’re given several choices. There are different types of health insurance plans and they are grouped by the level benefits they provide:
- Platinum
- Gold
- Silver
- Bronze
- Catastrophic Plan
Each of these plans pay a set share of costs and details can vary. Moreover, the amount you pay before your coverag]e kicks in, which is referred to as deductibles, also vary according to plan. It follows that the least expensive of these plans have the highest deductibles.
- Platinum plans cover an average of 90% of your medical expenses.
- Gold plans cover an average of 80% of your medical expenses.
- Silver plans cover an average of 70% of your medical expenses.
- Bronze plans cover an average of 60% of your medical expenses.
- Catastrophic plans pay below 60% on average. These plans include the first 3 primary care visits and free preventive care.
Health Maintenance Organization (HMO)
HMOs provide health services through a health care providers and facilities’ network. With this option, you have the least amount of paperwork compared to other types of health plans because your primary care physician will be the one to manage your care and refer you to a specialist if needed. On the other hand, you have less freedom in picking your doctors. If you pick a doctor who does not belong to the HMO’s network, you will have to foot the bill yourself.
Preferred Provider Organization (PPO)
With this type of health plan, you have some freedom to pick your doctors and facilities, compared to HMOs. You won’t need a referral from your PCP to see a specialist. However, you’ll pay higher out-of-pocket costs should you choose to see a doctor outside your network (compared to seeing a doctor who belongs to your network) and you’ll also have to deal with more paperwork.
Exclusive Provider Organization (EPO)
Just like with a PPO, you have some freedom to pick your doctors and you won’t be required to get a referral from your PCP if you need to see a specialist. On the other hand, it does not offer any coverage for providers outside your network, except during an emergency. On the upside, you will pay a lower premium with the EPO compared to a PPO.
Point-of-Service Plan (POS)
This type of health plan combines the features of a PPO and an HMO. With it, you have the freedom to pick your doctors and deal with a moderate amount of paperwork, should you decide to see a provider outside your network. You’ll need a referral from your primary care doctor to see a specialist. You pay less with in-network providers but you can see out-of-network providers at an added cost.
Catastrophic Plan
You may be wondering what a catastrophic plan is. Of all the different types of health insurance plans, this may be the most affordable. It’s something you can get if you’re under 30 and in good health. With this type of plan, you get 3 primary care visits and free preventive care, and your premiums are significantly lower than all other plans.
On the other hand, your deductible is also higher. For an individual plan, your deductible is $7,150 and for families the deductible is $14,300 before your coverage will kick in.
Deciding what plan is right for you requires research and contemplation, but it’s essential to ensure you have coverage so you can be prepared to face whatever life throws at you.
