Everyone needs to have health insurance at some point in their adult lives, especially if you are planning to start a family and have children. And when you’re planning to get health insurance and move into that next phase of your life, there are a few things you’ll want to keep in mind about what to look for.
And one thing you’ll also want to keep in mind when choosing what sort of health insurance plan works for you is that you’ll end up needing to pay more (or less) depending on what you choose.
Here are some of the different options available to you:
Health maintenance organizations (HMO)
An HMO will provide you a list of all doctors, nurses, specialists, hospitals, and healthcare professionals that are in your network for you to potentially choose from. You will need to choose a primary care provider (PCP) to be able to look at other specialists and different types of healthcare providers. Your PCP will be the one who keeps all your medical records and will coordinate all subsequent care that you need.
Copays and coinsurance involved in HMO insurance plans are usually lower than other types of health insurance plans, so long as you go to doctors that are within your network. Anything outside of your network will cost more.
Exclusive provider organizations (EPO)
Through an EPO, you will be able to choose again from a network on local providers that you can use with your insurance plan. Unless it’s an emergency, you won’t be able to get out of network care with an EPO. Going outside of your network means you would have to pay for the full costs of healthcare services. If you want to see a specialist, however, you don’t need a referral from a PCP.
Preferred provider organizations (PPO)
With a PPO plan, you will have a large network of providers to choose from, and you can also see people outside of your network for an additional cost. You also don’t need to have PCP for referrals with this type of plan.
Point of service plan (PSO)
A PSO plan is a combination of HMO and PPO plans. The provider network is often smaller than what is involved in a PPO plan, and the costs for any in-network providers will be cheaper. Like an HMO plan, you will need to choose a PCP, who will need ot provide referrals for any specialists and will serve as your home base again for all your medical records.
