Types of Health Insurance Plans

One way to ease the health insurance shopping process is by comparing options and selecting a specific type of health insurance plan to shop for in the marketplace. Easier said than done, especially if you’re unsure what the difference is between plan types, which most people are.

Take a look below at the breakdown of the most common types of health insurance plans.

Health Maintenance Organization (HMO) Insurance

• Requires a primary care physician, who manages your health care needs and refers you to specialists that are within your network of coverage.
• Limited freedom in your choice of health care providers.
• Out-of-pocket costs are easily predicted.

Comparing Costs:

• Monthly premium, typically lower than the PPO premium.
• Co-pays for doctor visits and prescription medications

Preferred Provider Organization (PPO) Insurance

• Offers greater freedom in your health care when compared to the HMO.
• You can choose which physicians you want to see, but you may pay extra for doctors that are not in your plan’s network.
• Out-of-pocket costs are typically higher than those for an HMO plan.

Comparing Costs:

• Monthly premium, which is typically higher than the HMO premium.
• Deductible, what you’ll be expected to pay for health care services before your health insurance company will begin covering costs.
• Copays for doctor visits and prescription medications.
• Coinsurance, the amount you’ll be expected to pay after you’ve reached your deductible.

High Deductible Health Plan (HDHP)

• Higher deductible, which means higher out-of-pocket costs for you.
• HDHPs are typically usually a specific type of a PPO.
• Often offer greater freedom in your health care when compared to the HMO.
• HDHPs are the only plans that are eligible for enrolling in a Health Savings Account (HSA)

Comparing costs:

Monthly premium, which is typically the lowest when compared to other plan types.
High deductible, amount you’ll have to pay for the health care services you use before your health insurance company will begin covering costs.
Copays for doctor visits and prescription medications.
Coinsurance, the amount you’ll pay after you reach your deductible.

Catastrophic Health Insurance Plan

• Only available if you’re under 30 years old.
• Higher deductible and out-of-pocket costs.
• Covers up to three visits to a primary care physician
• Catastrophic plans are not subsidy eligible.

Comparing costs:

• Monthly premium, which is typically very low.
• High deductible, which is the amount you’ll be expected to pay before your insurance company begins covering health care costs.
• You may have to cover the costs for doctor visits and prescription medications.