Types Of Healthcare Coverage

doctors-office.ju.topHealthcare coverage can give you peace of mind that your hospital bills will be paid when you need to seek medical assistance. Many countries have local healthcare coverage for its citizens, and some can be availed through private insurance organizations. The most common sources of healthcare insurance come from your employer, union or organization, or from your spouse’s insurance as a secondary beneficiary. Alternatively, you can pay the premiums straight from your pocket. Healthcare organizations often provide coverage based on the medical service provided, as well as the plan type (usually categorized as “Platinum,” “Gold,” or “Silver”), which ultimately determines the percentage covered.

Health Maintenance Organizations (HMO)

Health Maintenance Organization insurance, or HMO insurance, is that which is typically provided by your employer. The premiums are paid, or partially paid, by your company as part of your benefits. Like most healthcare types, you are limited to the doctors and hospitals that are members of the HMO network.

Preferred Provider Organizations (PPO)

A PPO is like a discount card: you’ll pay less money if you avail services from doctors, clinics and hospitals that are part of the network. You can also use other medical facilities and specialists that are not members of the network by obtaining a referral, but those come with additional fees.

Point-of-Service plan (POS)

A Point-of-Service plan is a combination of the HMO and POS plans. It has the same structure as the other types when it comes to using medical services within the network. However if you need to see a specialist, you will need a referral from your primary doctor.

High-Deductible Health Plan (HDHP)

Paired with a health savings account, the HDHP has low monthly premiums but high deductibles. This plan is ideal for people who don’t need to schedule regular doctor visits and who are looking for insurance policies that only cover you in extreme cases, meaning you only need coverage for major emergencies and illnesses. Regular doctor visits are expensive through this plan because you will need to pay more out of your pocket, but if you’re healthy, you don’t have to worry as much about that. And if something does happen wherein you would require emergency medical services, HPDP can provide either comprehensive or supplementary coverage.

Exclusive Provider Organization (EPO)

With an EPO, you can avail services from accredited hospitals, healthcare facilities and doctors that are exclusively part of the healthcare organization. Some companies provide partial coverage for emergencies through an EPO.

Indemnity or “Fee-for-Service” Plan

Some insurance companies provide indemnity plans wherein you co-share medical bills. These plans set a limit that you need to spend before the insurance will pay for covered costs. This means that not all expenses are covered, and that there are lab tests, consultation specialists, and other medical procedures that are shouldered by the company. Anything outside of that list will be coming out of your own pocket.