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Types of Health Insurance Plans:

Know Before You Choose

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Picking A Health Insurance Plan, What’s Important

When it comes to health insurance plans things can sometimes be overwhelming. However, at Fika Insurance we are to help make it simpler process. Let us start by going over 3 basic things everyone needs to know before comparing health plans.

There are 4 categories of health insurance plans: offered through the Health Insurance Marketplace®: Bronze, Silver, Gold and Platinum. The metal types represent how you and your insurance plan are going to share in the cost of your healthcare expenses.

The total cost for your health care: Customers will pay a monthly bill (premium) to the insurance company, even if they do not use the insurance coverage that month. Also, customers are responsible for expenses like out-of-pocket cost such as a deductible when they receive care. So, it is important to think about all costs when shopping for a plan.

Plan and Network Types: While some plan types allow you to use almost any doctor or health care facility of your choice others, may limit your choices or change you extra if you do not use their network of doctors or facilities.


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What Do the Different Types of Health Insurance Plans Mean?

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 will not 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.