Knowledge — 3 years ago

What Types of Medical Insurance You Should Know About

by infohub

Types of Health Insurance and How to Choose Health Insurance

Medical insurance is essential these days as it helps you get the medical assistance you need without having to cover all the bills on your own. Many people don't know what types of medical insurance are available to them, and if you are one of them, you should read this and find out what health insurance you can get to cover you when you or one of your family members need medical assistance of any type:

Where to Get Medical Insurance?

Before deciding on a medical insurance plan, you have to find out which one of these two types your state provides:

1. Private Health Insurance Marketplace – the Health Insurance Marketplace is part of the Affordable Care Act (ACA) that the Congress passed in 2010. The Health Insurance Marketplace is state-provided medical insurance that allows individuals with no employer-sponsored coverage to compare and choose the plan that is right for them – i.e., survey the market for the best medical insurance out of private insurers. Not all US states have an open medical insurance marketplace, which means they are part of the federal exchange program. The Health Insurance Marketplace includes several types of coverage as follows - bronze, silver, gold, and platinum, with the platinum coverage providing up to 90% of medical expenses.

types of medical insurance - a doctor writing on a medical chart
Source: shutterstock

2. Federal Exchange Program – this is the most common health insurance in America, and most states chose it as the plan for their residents. The federal exchange health insurance is also a marketplace for insurers, but you can select your provider from a list approved by the state. This means that you have fewer options than in the open marketplace and you can't choose any health insurance provider that you want.

Each state has different rules when it comes to health insurance, so it's important to find out which plans your state offers and choose the best one for yourself and your family.

Types of Marketplace Plans

After you find the kind of health insurance that is available in your state, you can choose one of the following programs based on your need:

Health Maintenance Organization (HMO): The HMO plan focuses on keeping you well and preventing illness, and this type of plan only allows you to use doctors that have a contract with HMO. In this plan, the list of doctors you can use is limited, and you get out of the network only in case of an emergency. Some HMO plans require you to live in their service areas to get the coverage when you need it.

types of medical insurance - a phone with the words health insurance written on it
Source: shutterstock

Exclusive Provider Organization (EPO): In the EPO plan, you get coverage only if you use hospitals, specialists, and doctors that are in the network listed in the program.

Preferred Provider Organization (PPO): The PPO plan allows you to pay less money when you use the providers listed on the network's plan. If you want to choose service providers that are not on the network's list, you can do so but with additional costs.

Point of Service (POS): This plan is similar to the PPO, meaning that you pay less if you choose providers from the network's list. To go to a specialist, you will need a referral from your doctor.

types of medical insurance - a woman's hand's holding a child's hand with a wounded heart between them
Source: shutterstock

Every state is the US provides a different type of health insurance. Whether it's a free marketplace or a federal marketplace, you can compare prices and coverages and choose the best health insurance plan for you.


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