Attempting to purchase a health insurance plan can be a complicated process. It is wise to do some research before committing to a program. The cost of healthcare can be substantial if you do not have the right coverage.

The Differences Between Health Insurance Plans

Still, a popular perk for the working class is having an employer-provided health insurance plan. The types of benefits included in the healthcare plan are the deciding factor in accepting a job with a company. The quality of the coverage offered helps a person to remain loyal to an employer. The most popular employer-provided health insurance plans are Health Maintenance Organizations (HMO), Point-of-Service Plans (POS), and Preferred Provider Organizations (PPO).

Before choosing a health insurance plan, you need to have a better understanding of the benefits offered in the different health insurance plans. Consider each to be a network of healthcare providers (hospitals, medical facilities, physicians, and healthcare professionals) that offer medical services at a discounted rate.

The difference between the plans is the out-of-network coverage offered. In some health insurance plans, you could pay full price for out-of-network care. Often, your company’s health insurance provider will not accept reimbursement claims for medical expenses outside the network.

If you are unsure which health insurance plan is best for you, it is wise to seek assistance from Margolis & Associates. They help clients become familiar with the terminology used in employer-provided healthcare plans.

Health Maintenance Organizations (HMOs)

HMOs are the most affordable health insurance plans available on the market today. It helps those workers on a fixed budget as their copay will be much lower than other health insurance plans. The plan consists of a network of hospitals, physicians, and other healthcare professionals who provide care for individuals. During the sign-up process, you must select a primary care facility from a list of participating hospitals and medical centers. Once a selection is made, you will choose an HMO primary physician for your annual checkup. They have the authorization to refer a specialist to treat certain medical conditions. However, the cost increases if you elect to go outside the network for treatment.

Point-of-Service Plan (POS)

Healthcare experts believe POS is a combination of the other popular plans. The copay is lower than most healthcare programs because the number of network options is smaller. Like other health insurance plans, you must select a primary medical facility and a physician that will provide all of your medical needs. And if you need to see a specialist for a diagnosed medical condition, you can seek one outside the network. The cost will be slightly higher than an in-house option.

Preferred Provider Organizations (PPO)

The advantage of having a PPO is the plan offers the largest number of healthcare facilities and professionals to choose from. It is in your best interest to do research before making your selections. And if you decide to see a specialist outside the network without a referral, you will not be penalized for such actions. Simply put, a PPO plan is the right choice for those who can afford higher copay rates. 

Contact a Professional

Margolis & Associates can help you find the best health insurance in NYC. If you’re unsure what plan is right for your lifestyle, let the experts provide the experience to assist in making the right choice. Contact us today!