Submitted by Star Pollard, Financial Solutions Contributor, Jacksonville District
There are different types of health insurance plans designed to meet different needs. Some plans restrict or encourage the insured to get care from the network of doctors, hospitals, pharmacies, and other medical service providers. Others pay a greater share of costs for providers outside the plan’s network.
Types of plans
Depending on how many plans are offered, shoppers may find policies that include some or all of these metal levels: Bronze, Silver, Gold, and Platinum. There are also different types of catastrophic plans.
Some examples of plan types you’ll find in the Marketplace:
Exclusive Provider Organization (EPO): A managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan’s network (except in an emergency).
Health Maintenance Organization (HMO): A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.
Point of Service (POS): A type of plan where you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. POS plans require you to get a referral from your primary care doctor in order to see a specialist.
Preferred Provider Organization (PPO): A type of health plan where you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost.