Different Types of Private Health Insurance

When shopping for private health insurance, you may feel that having a variety of options is an advantage, which it is, but it can also make the process a little challenging to work through.  Depending on the benefits and coverage you are looking for, there are four basic levels that you will have the option tomake your choice from.  They include the levels of bronze, silver, gold, and platinum.

The bronze level plans will offer the least amount ofcoverage, while at the same time, the platinum level plans will offer the mostchoices of coverage.  Worth noting isthat if you are under 30 years old, you may have the option for a plan with ahigh-deductible, catastrophic-based plan.

To make the proper choice for you and your family, you willneed to understand how the plans differ. Basically, for the average person enrolled in a given plan, the enrolleewill pay a set share of costs.  Essentialto remember is that the specific  detailswill vary according to the program and the company offering it.

Another part that will vary according to the plan will bethe deductible.  The deductible is thepart that you are responsible for out of your pocket each year before theprogram will kick in and pay, in some cases, up to 100% of the cost of yourhealth care.  Generally, the leastexpensive plan will most often carry the highest deductible rate.

On average, each level of the following private healthinsurance plans offers:

-         Platinum – averages covering 90% of medical expenseswith your part being 10%

-         Gold – averages covering 80% of medical costswith your part being 20%

-         Silver – averages covering 70% of medical costswith your part being 30%

-         Bronze – averages covering 60% of medical costs,with your part being 40%

-         Catastrophic – once you have reached a somewhathigh deductible (reportedly averaging $8,150 in 2020), this plan's paymentswill kick in.  The program must coveryour first three visits for primary care, and any preventative care for free,even if your yearly deductible has yet to be met.

The top national brands such asUnited, Cigna, Blue Cross Blue Shield, and Aetna will offer one or even more ofthe following common types of private insurance plans:

-         HMO – Health Maintenance Organization

-         PPO – Preferred Provider Organization

-         EPO – Exclusive Provider Organizations

-         POS – Point of Service

Taking the time to research and learn what each of theseplans offers will aid you in determining the best fit for your health careneeds and your financial budget.  We haveprovided a summary of the benefits of each plan below.

HMO – Health Maintenance Organization

-         You have the least amount of freedom in thechoice of your health care provider

-         The plan offers the least amount of paperwork onyour side

-         Requires a primary care physician that willmanage your care and, if necessary,

-          refer youto specialists when needed and determine that the specialist is covered underthe plan.

-         You are responsible for paying a premium, adeductible, and any co-pays, but there are no claim forms to be filled out onyour part.

PPO – Preferred Provider Organization

-         You will have a moderate amount of freedom inthe choice of your health care provider

-         There is more paperwork involved, especially ifyou choose to see a physician out of network.

-         A referral by your primary care physician willnot be needed see a specialist is not required.

-         You are responsible for paying a premium, adeductible, any co-pays, and any balance due to out-of-network physicians youchoose to see.

EPO – Exclusive Provider Organization

-         You will have a moderate amount of freedom inthe choice of your health care provider

-         There is little to no paperwork necessary onyour part

-         A referral by your primary care physician forsee a specialist is not required

-         No coverage for those physicians deemed as outof network – other than an emergency

-         You are responsible for paying a premium, adeductible, any co-pays, and any amount due for seeing an out of networkphysician

POS – Point Of Service

-         You have more freedom in the choice of your healthcare provider

-         There is a moderate amount of paperwork,especially if you choose to see an out of network physician

-         A referral by your primary care physician forsee a specialist is not required

-         You are permitted to see physicians out ofnetwork, but there will be an additional cost

-         You are responsible for paying a premium, adeductible, and any co-pays.

Catastrophic

-         The premium is lower

-         The deductible doesn’t kick in until after threeprimary care visits

-         Preventative care is free even if the your deductiblehas is yet met

-         You are responsible for paying a premium, apredetermined deductible, and you will be responsible for keeping track of andrecording your payments, proving that you have met the deductible.

Here at Savvi Health, our mission is to help people take thestress out of buying health insurance in Houston, Texas, San Antonio, Dallas, AnnArbor, and Grand Rapids.  Feel confidentby knowing that you'll have the absolute best plan that fits your lifestyle &budget.  We look forward to working with you.

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