In exchange for regular payments (premiums), one party (the insurer) offers to compensate another (the policyholder) for the cost of medical care incurred. This financial arrangement is known as health insurance. Prescription medication, hospital stays, surgeries, doctor visits, and preventive care are usually included. There are various plan kinds with different amounts of flexibility, out-of-pocket expenses, and network limits. The best plan to choose will rely on your budget and personal needs.
There are four prominent categories of health insurace:
HMO (Health Maintenance Organization): HMOs require a primary care physician to coordinate care, with specialists only available if referred by the PCP, offering lower premiums compared to other health insurance types.
PPO (Preferred Provider Organization): PPOs offer flexibility in choosing doctors or specialists, but may incur higher out-of-pocket costs for non-network doctors, with higher premiums compared to HMOs.
POS (Point-of-Service): POS plans combine HMOs and PPOs, offering options for in-network or out-of-network doctor visits, with premiums typically between HMOs and PPOs.
EPO (Exclusive Provider Organization): EPO plans provide coverage for care from in-network providers, like doctors, hospitals, and specialists, who have contracted with the insurance company to offer discounted rates.