Health Insurance Plan Types and Definitions

Health Insurance Plan Types and Definitions

Health Insurance Plan Types and Definitions

There are many different types of Individual Health insurance plans available for purchase in today’s rapidly changing healthcare marketplace. The summaries below will hopefully be useful in explaining the differences and nuances between each health plan type.

HSA (Health Savings Account)

The Health savings account is the new name for the Medical savings account (MSA) plans in the United States. The provisions of the MSA were made more advantageous and available to more people in the new HSA. The changes were made in legislation signed by George W. Bush on December 8, 2003. (more on Health Savings Accounts)

HMO (Health Maintenance Organization)

Health Maintenance Organization (HMO) is a type of Managed Care Organization (MCO) that provides a form of health insurance coverage that is fulfilled through hospitals, doctors, and other providers with which the HMO has a contract. Unlike traditional indemnity insurance, care provided in an HMO generally follows a set of care guidelines provided through the HMO’s network of providers. Under this model, providers contract with an HMO to receive more patients and in return usually agree to provide services at a discount. This arrangement allows the HMO to charge a lower monthly premium, which is an advantage over indemnity insurance, provided that its members are willing to abide by the additional restrictions.

Medicare Supplement Plan

Also known as Medigap insurance, this privately sold insurance policy fills the “gaps” in Medicare coverage. There are 10 standardized policies labeled Plan A through J. Medigap policies only work with the Medicare plan. (more on Medicare Supplement Plans)

PPO (Preferred Provider Organization)

Preferred Provider Organization (or “PPO”) is a managed care organization of medical doctors, hospitals, and other health care providers who have covenanted with an insurer or a third-party administrator to provide reduced rates to the insurer’s or administrator’s clients. (more on Preferred Provider Organizations)

POS (Point of Service Plan)

A POS Plan is a managed care plan where the benefits are determined at the point the member decides to use either In-Network or Out-Of-Network services. This gives members greater freedom of choice. When a member remains In-Network or uses a participating provider, benefits are provided as an HMO (low out-of-pocket expenses and no deductible or claim forms. Members choosing Out-Of-Network benefits will have reduced benefits and higher out-of-pocket expenses.

Health Insurance Plans with Maternity Coverage

Health Insurance Quotes & Information

Many health insurance plans do not offer benefits for maternity coverage, without a costly rider, and some others still consider a pregnancy to be a pre-existing condition.  Consequently about 13% of pregnant women go without maternity coverage (sometimes unknowingly) and run the risk of crippling out of pocket costs for the birth and/or inadequate pre-natal care.

If you are pregnant or plan on becoming pregnant in the near future, it is important that you make sure that you are covered to defray healthcare costs as well as insuring that you receive the best pre-natal care available for you and your baby.

Simply enter your zip-code above to begin comparing health insurance plans with maternity benefits.  It’s easy.

Vision Coverage

Vision insurance differs from regular health insurance coverage because it is essentially wellness benefit that helps defray costs of eye exams, eyewear, and other vision services.

However, often vision coverage is included as a value-added benefit linked to your major medical health insurance plan ( including indemnity health insurance plans, HMOs, PPOs etc.) that have contracted with managed vision care networks to provide eye care services.

To compare individual health insurance plans with built in vision benefits simply enter your zip code above to begin.   It’s fast, easy, and could save you money.

Catastrophic Health Coverage

Catastrophic health insurance coverage is typically sought by individuals and families who do not really want to carry the expense of health insurance, but recognize that it is important to have in the event of a catastrophic accident or injury.

Catastrophic coverage is generally characterized by high-deductibles, low monthly premiums and coverage for doctor’s visits and prescription drugs are paid out of pocket by the enrolled member.

Individuals who purchase catastrophic coverage tend to be very healthy, and don’t utilize medical care often.