Health Insurance 101: A Primer on Understanding Plan Types
The Complete Guide to Understanding Health Insurance Plans
Health insurance can be confusing, especially with all the plan options out there. At FirstQuote Health, we want to help simplify things so you can find coverage that truly fits your needs and budget. In this comprehensive guide, we’ll explain the key types of health insurance plans, who they are best suited for, what’s covered, and more.
What is Health Insurance?
Health insurance helps pay for medical expenses incurred for preventive care, illnesses, injuries, and more. Plans help cover costs like doctor visits, hospital stays, prescriptions drugs, mental health services, and additional healthcare services.
There are several common types of plans offered by providers:
Preferred Provider Organization (PPO) Plans
PPOs contract with a network of preferred providers who offer services at a discounted rate. You pay less when using in-network providers. You can go out-of-network but will pay more. PPOs offer flexibility to see specialists without referrals. They have moderate premiums and deductibles.
Best for: People who want in-network benefits but flexibility to choose out-of-network care.
Health Maintenance Organization (HMO) Plans
HMOs only cover in-network care. You must choose a primary care physician to coordinate care and refer you to network specialists. Out-of-network care is only covered in emergencies. HMOs have lower premiums but less flexibility.
Best for: People who primarily want to minimize monthly costs and are comfortable staying in-network.
Short Term Health Insurance Plans
Also called temporary insurance, these plans offer affordable coverage for a limited time period, such as 3 to 12 months. They have more flexibility in terms of enrollment qualifications. Short term plans have lower premiums but less comprehensive coverage.
Best for: People needing temporary coverage between jobs or major life transitions.
High Deductible Health Plans (HDHPs)
HDHPs have lower monthly premiums but a high deductible you must pay out-of-pocket before coverage kicks in. Most HDHPs can be paired with a tax-advantaged Health Savings Account (HSA) to help cover medical expenses.
Best for: Healthy individuals who rarely need medical services and want to save on premiums.
Catastrophic Health Insurance Plans
These bare-bones plans protect you from worst-case medical scenarios. They have very low monthly premiums and a very high deductible. Catastrophic plans cover three primary visits per year at no cost and free preventive services.
Best for: People under 30 or those facing financial hardship who want basic protections.
Choosing the Right Plan
When selecting a health insurance plan, consider your expected healthcare needs, budget, and personal preferences. Do you want more flexibility or lower costs? Think about plan features like premiums, deductibles, copays, coinsurance rates, and network coverage.
Our licensed agents can answer questions and provide free quotes on these plans to help you make the optimal choice. There is no obligation to enroll. We look forward to helping you find coverage to protect your health and finances. Contact us today to get started!