Health insurance is coverage that provides for the payments
of benefits as a result of sickness or injury. Includes insurance for losses
from accident, medical expense, disability, or accidental death and
dismemberment.
Health Maintenance Organizations (HMOs) and Exclusive
Provider Organizations (EPOs)
- HMOs
and EPOs may limit coverage to providers inside their networks. A network
is a list of doctors, hospitals, and other health care providers that
provide medical care to members of a specific health plan. If you use a
doctor or facility that isn't in the HMO’s network, you may have to pay
the full cost of the services provided.
- HMO
members usually have a primary care doctor and must get referrals to see
specialists. This is generally not true for EPOs.
Preferred Provider Organizations (PPOs) and
Point-of-Service plans (POS)
- These
insurance plans give you a choice of getting care within or outside of a
provider network. With PPO or POS plans, you may use out-of-network
providers and facilities, but you’ll have to pay more than if you use
in-network ones. If you have a PPO plan, you can visit any doctor without
a referral.
- If
you have a POS plan, you can visit any in-network provider without a
referral, but you’ll need one to visit a provider out-of-network.
High Deductible Health Plan (HDHP)
- High
Deductible Health Plans typically feature lower premiums and higher
deductibles than traditional insurance plans.
- If
you have an HDHP, you can use a health savings account or a health
reimbursement arrangement to pay for qualified out-of-pocket medical
costs. This can lower the amount of federal tax you owe.
Catastrophic Health Insurance Plan
- A
catastrophic health insurance plan covers essential health benefits but
has a very high deductible. This means it provides a kind of "safety
net" coverage in case you have an accident or serious illness.
- Catastrophic
plans usually do not provide coverage for services like prescription drugs
or shots.
- Premiums
for catastrophic plans may be lower than traditional health insurance
plans, but deductibles are usually much higher.
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