In order to make sure that you are covered in the event of a medical emergency it is important to be aware of the different types of medical insurance. If you are uninsured, or do not have the necessary medical coverage, any major medical problem that you encounter will have a significant impact on your personal finances.
In America today, the PPO (Preferred Provider Organization) is the health insurance plan of choice for the majority of people with private health insurance. PPOs require you to use in network doctors and facilities, but do not typically require referrals for specialists. PPOs usually require you to pay a co-pay when you see your doctor, or go to the hospital or a walk-in clinic. Based on the strength of your insurance company, and where you live, there may be many doctors and facilities available for you to choose from, or there may not. This is definitely something that should be researched before making a decision to join a PPO plan.
The less expensive your copay and the higher your insurance’s coinsurance contribution, the more expensive your monthly premium will be. Other coverage, such as coinsurance for mental health treatments and substance addiction, varies by state. If you are already undergoing medical treatment for a condition, make sure you discuss how your insurance will cover your particular issue.
If you are interested in a plan that will not limit you to certain doctors or facilities, then an HDHP (High Deductible Health Plan) may be right for you. The HDHP is a health savings plan, that deducts money from your salary each month before taxes are applied. The money is saved in either a Health Savings Account or a Family Savings Account. When you incur medical expenses, whether it is for doctors visits, medicine, or other over the counter health care needs, you can use the money in your HDHP to cover the costs. If you choose a Family Savings Account the savings can even be used for child care. One additional benefit with an HDHP is that certain doctors may provide a discount to HDHP participants.
The HMO plan (Health Maintenance Organization) is a plan similar to a PPO, but geared towards older adults. The HMO plan requires you to choose a PCP (Primary Care Provider) to be your main doctor. Any time you want to see a specialist it is necessary for you to first see your PCP, in order to obtain a referral for a specialist. HMOs also require you to choose from doctors and facilities that are in network, and like a PPO there are co-pays and monthly premiums, which dictate how much the insurance company will cover.
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