Health Insurance Plans Explained

Health insurance plans can seem complex and confusing at first glance. From various plan types to coverage options to costs, it can feel overwhelming trying to find a plan that fits your budget and your medical needs.

However, with a bit of insight and a few helpful tips included in the slides below, you can be well on your way to understanding all your health care options. From HMO insurance to various other coverage types, you can learn about the most important features of a good healthcare plan and make an informed decision for you and your family. 

HMO Insurance 101
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Finding the right health insurance coverage types depends on a few personal factors, such as how often you seek medical care and how much you can afford to pay. Not everyone will benefit from the same type of plan.

However, if you are looking for the least expensive type of insurance, a Health Maintenance Organization (HMO) plan may be right for you. HMO insurance generally has the lowest monthly premium, which is a set amount of money you pay each month to keep your insurance.

HMO health insurance has low monthly premiums because these plans require you to seek care from in-network providers, which are doctors and health care facilities that operate within a health insurance company’s system. The size of the network and availability of providers varies depending on the health insurance company.

Because of the way in which HMO insurance works, some individuals may not benefit from an HMO plan. For example, those who require frequent or complex medical care may struggle to find providers in their plan’s network and may need to pay additional costs for seeking care from out-of-network doctors instead.

This is because everyone enrolled in an HMO health insurance plan is required to choose a primary care provider (PCP) from within the company’s health network. The PCP serves as the insured’s go-to for all types of standard medical care.

If you are enrolled in an HMO plan and need specialized care, the PCP will refer you to a specialist in the network, if one is available. If you wish to see an out-of-network specialist, your HMO plan will not cover the cost.

However, it is important to note that the HMO insurance plan WILL cover the cost of any out-of-network emergency medical care.

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By Admin