January 2021
« Sep    
Search Homepage

Types of Health Coverage Plans

If you have ever dealt with health coverage plans you definitely know that there are various types of plans out there on the market, each of them having their special features, pros and cons. And it’s quote hard to say which plan type is better, because they all appeal to different customers and different situations. Just like you can’t say that coffee is better than tea, you can’t affirm that HMOs are better than PPOs. So if you are a bit confused with different plans and don’t know which one to choose, this short overview will definitely help you decide with type of health coverage to purchase when you decide you need one.

Health Maintenance Organization (HMO)

This plan type is probably one of the most popular and widely used amongst managed care plans. It delivers a very wide selection of services, including preventive care, regular exams, access to different specialists and medications. However, you are limited to a specific network of medical facilities and physicians you can receive services from. Moreover, you are required to choose a primary car physician (PCP) who will refer you to other specialists when needed. Otherwise, if getting your care outside the network or without your doctor’s referral you will have higher out of pocket expenses.

Preferred Provider Organization (PPO)

PPOs are practically identical to HMOs, taking the fact that you are also limited to a network of facilities and have to choose a PCP in order to receive care. However, you have more freedom when choosing your primary physician, which is especially helpful if you have a good relationship with your family doctor who is out of the network. And you usually get a wider network of facilities to receive care in. Still, any out of network services will be considerably more costly.

Point of Service (POS)

POS plans have strict rules concerning referrals. If you don’t have a referral to other specialists issued by your primary physician then you won’t be able to receive any cheap health insurance coverage at all.

Exclusive Provider Organization (EPO)

EPOs are very close to HMO and PPO plans. It’s the same type of managed care health insurance where you have to select a PCP and are limited to a network of hospitals and doctors you can get medical services from. But the main difference is that with EPO plans you pay for each visit to the doctor or service received when required in contrast to HMO plans where you have a monthly fee that should be paid constantly regardless whether you have used your coverage or not.


Fee-for-Service is the oldest type of individual health insurance that was around ever since health coverage was introduced. With such plans you have total control over where to get your care and whom to address. You pay only for the services you receive and don’t need any referrals in order to get to a specialist. However, the fees are usually much higher than with managed care plans and many insurance experts say that the resulting out-of-pocket expenses are larger than the amounts of money you would spend on a managed care plan.

Now it’s up to you to decide which plan type works best for you. Analyze your situation, see what your options are and get the plan that would reflect your personal interest and would be most convenient to you personally.

About Author
If you have found this article interesting you can visit its Norris Rios’s site for more writings. Norris Rios has spent years in perfecting his journalist skills and is pleased to share his vision with you.

Comments are closed.

Social Widgets powered by