In 2018, 91.5 percent of Americans had health insurance for all or part of the year. Only about 8.5 percent of people, or 27.5 million, did not.
These are good numbers, showing that most US citizens value the coverage of health insurance. However, we believe those numbers could still be higher. If this pandemic has taught us anything, it’s that making health and wellness a priority is absolutely essential.
Some people are confused by the different types of health insurance coverage, and that’s understandable! It’s a complex topic—but it doesn’t have to be. Here, we break it down in an understandable way, so that the uninsured can feel confident the next time they apply.
Let’s get started.
The 3 Types of Health Insurance Coverage, Explained
Health insurance coverage types can be broken down into three categories:
- Preferred Provider Organizations (PPO)
- Health Maintenance Organizations (HMO)
- Exclusive Provider Organization (EPO)
Let’s dive deeper into these three types.
Preferred Provider Organizations
When someone has PPO coverage, they can visit a wide variety of doctors and specialists, and without needing a referral to do so first. This is typically a good plan for someone who visits specialists often.
With PPO coverage, plan members can visit a vast network of doctors and hospitals without having to get a referral from their primary care physician (PCP). In most cases, you do not have to choose a PCP, either, but can change as needed.
Because of the great coverage provided under this plan, it’s pretty flexible, but it does come with a higher price tag.
Health Maintenance Organizations
HMOs are perhaps the most common type of health insurance coverage.
In this case, there is still an extensive network of doctors and hospitals willing to provide care. Nevertheless, you need a referral from your designated PCP first—especially if visiting a specialist. This takes away a little of the freedom of a PPO plan.
However, HMOs are the most affordable of the different types of health insurance coverage.
Exclusive Provider Organization
With EPOs, expect a plan that is a mix of PPO and HMO.
Here, you typically get a little more flexibility than you would in an HMO plan. You can use any healthcare providers you need, as long as they’re within the EPO network. If they’re not within the provided network, you will pay for your visit out-of-pocket.
Often, you don’t need a referral from a PCP first to see a specialist.
Since you can’t go outside of the EPO network for care, expect a lower price than a PPO plan.
Get Insured!
Now that you have a better grasp of the various types of health insurance coverage, you should feel better about applying for what you need.
If you want coverage, we can help. We provide all types of coverage, as well as work with multiple health companies and plans. Whether you need individual or family coverage, short-term or private, Just Us Insurance Services provides it all.
We accept those with pre-existing health conditions and those who need to stay with a specific doctor or specialist. If you have a qualifying event outside of open enrollment, we’d love to hear it. If you qualify for a tax subsidy, or you’re simply paying too much for health insurance—we can help!
Age is nothing but a number, either. We can provide insurance to those of all ages.
To Get a Free Quote reach out to Heather Gray
Heather/619-933-9517/ heather@justusinsurance.
