Making Sense of Health Insurance

We believe choosing a health plan should be clear and straightforward. This guide breaks down the essential terms and plan types to help you select the coverage that's right for your life and budget.

Common Health Plan Types

Each plan type offers a different balance of flexibility, cost, and network access. Here’s a look at the most common options.

HMO Plans

Health Maintenance Organization plans typically require you to use doctors and specialists within its network and choose a Primary Care Physician (PCP).

  • Lower monthly premiums
  • Requires a Primary Care Physician
  • Referrals needed for specialists

PPO Plans

Preferred Provider Organization plans offer more flexibility to see providers both in and out-of-network without needing a referral, usually at a higher cost.

  • Greater choice of doctors
  • No PCP or referrals required
  • Out-of-network coverage available

EPO Plans

Exclusive Provider Organization plans are a hybrid, offering a specific network of providers you must use, but typically without requiring specialist referrals.

  • Moderate monthly premiums
  • Generally no specialist referrals
  • No out-of-network coverage
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Decoding Insurance Lingo

Understanding these key terms is the first step toward mastering your health coverage and avoiding unexpected costs.

A deductible is the amount you pay for covered health care services before your insurance plan starts to pay. For example, if you have a $2,000 deductible, you pay the first $2,000 of covered services yourself.

A premium is the fixed amount you pay for your health insurance plan, usually on a monthly basis. You must pay your premium to keep your coverage active, regardless of whether you use medical services.

A copay is a fixed amount you pay for a covered health care service after you've paid your deductible (e.g., $25 for a doctor's visit). Coinsurance is your share of the costs of a covered health care service, calculated as a percentage (e.g., 20%) of the allowed amount for the service.
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How to Choose the Right Plan

Your ideal plan depends on your unique health needs, budget, and preferences. Consider these factors when making your decision.

  • Evaluate Your Budget

    Balance your monthly premium with the out-of-pocket costs like deductibles and copays that you can comfortably afford.

  • Check the Provider Network

    If you have preferred doctors or hospitals, ensure they are in the plan's network to maximize your benefits and minimize costs.

  • Review Prescription Coverage

    Look at the plan's formulary, or list of covered drugs, to see if your regular medications are included and what your cost will be.

Ready to Find Your Perfect Plan?

Our tools and advisors are here to help you compare options and enroll in the plan that provides the right coverage for your peace of mind.

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