With all the different insurance plans out there, it’s essential that you know what makes them different and how to determine the right one for you. In today’s blog, we will discuss the different insurance plans we offer and who benefits from them.

PPO Plan

PPO, or Preferred Provider Organization plans, are easily one of the most popular insurance plans in the Individual and Family market. PPO plans allow you to visit any in-network doctor, healthcare provider, or specialist you want without getting a referral from a primary care physician.

Members of PPO plans are encouraged to use the insurance company’s network of preferred doctors, and in-network healthcare services are covered at a higher benefit level than out-of-network services.

For this reason, it’s always important to check if your provider accepts your health plan so you can receive the highest level of benefit coverage.

In PPO plans, you will likely have to pay an annual deductible before you’re eligible to start receiving health coverage. You may also have a copayment of around $10-$30 for certain services, or you may be asked to pay a percentage of the total charges of your medical bill.

You might benefit from a PPO plan if you:

PPOs are great for people who want more freedom when it comes to their healthcare.

HMO Plan

An HMO, or Health Maintenance Organization plan, is an insurance plan that works with a contract network of hospitals, clinics, and healthcare providers.

HMO coverage can be available as part of a health, dental (or DHMO), or vision benefits plan. No matter the type of care, most HMO insurance policies are characterized by three main features: 

  1. Low coverage costs
  2. Referral requirements
  3. Stricter coverage guidelines

HMOs work with a network of healthcare providers contracted to offer care at a reduced rate for enrollees or members.

Primary care physicians (PCPs) are an important part of your HMO medical team, so it’s important to take your time and choose one carefully. PCPs coordinate your medical treatments and services during your coverage term. They’re also responsible for giving referrals when you need to see an in-network specialist.

HMO plans usually cover most of your costs when you get help from an in-network doctor or healthcare provider. 

Unlike a PPO plan, HMO plans usually don’t offer out-of-network care unless it’s an emergency. Although the plan’s guidelines for what constitutes an emergency might be very strict. Should your emergency not fall under the plan’s guidelines, you may not receive coverage, and these expenses will need to be paid out-of-pocket.

Many HMO plans come with fewer out-of-pocket expenses like deductibles, copayments, and coinsurance than a PPO plan.

The main benefits of choosing an HMO are the lower cost and high quality of care. 

HMO plans are great for people who want to spend less on their premiums and don’t mind staying within the insurance provider’s network of contractor healthcare providers.

EPO Plan

Similarly to HMO plans, EPOs, or Exclusive Provider Organization plans, also work with a network of healthcare providers and doctors within their plan’s network.

Some benefits of choosing an EPO plan are:

Suppose you’re a member of an EPO plan. After you get healthcare, your insurance company will pay for a portion of your healthcare costs, leaving you to pay for the remaining amount, depending on your deductible, coinsurance, and out-of-pocket costs.

An EPO plan won’t pay for out-of-network care, so if you receive care from a doctor or provider that isn’t in the insurance company’s network, you will need to cover the full cost of that care. 

In some cases, EPOs will cover emergency care, but you will need to speak to your insurance provider to see what their guidelines are for emergencies.

EPOs are the second most common type of health plan in the Affordable Care Act (ACA) marketplace.

EPOs are great options for people who don’t want to deal with the hassles of needing referrals to see specialists and who want to manage their own care without a primary care provider (PCP). They’re also good options for people who want some flexibility with their plan but don’t want to pay the high premium of a PPO plan.

POS Plans

POS, or Point Of Service plans, are like hybrid insurance plans. The reason they’re called POS plans is that you’re able to decide whether or not to stay in your insurer’s healthcare network. As the name suggests, the cost of this type of insurance plan all depends on the “point” of service, with the point being the healthcare provider or medical facility.

POS plans share some qualities of HMO and PPO plans. Benefit levels with POS plans will vary, depending on whether you receive your care in or out of the insurance company’s network of healthcare providers.

POS plans combine the elements of HMO and PPO plans.

Like with an HMO, you may have to designate a primary care physician who will then make referrals to other network specialists when needed. Depending on which POS plan you choose, the services that your PCP provides may not be subject to a deductible, and your preventative care benefits can be included in your policy.

And like with a PPO, you can receive care with non-network providers, which will result in a higher out-of-pocket expense. Sometimes, you can also be held responsible for copayments, coinsurance, and annual deductibles.

If you’re trying to save extra money on your monthly premium and don’t need healthcare services from an out-of-network provider, a POS plan might be a great option. 

PPO Dental

You already know what a PPO is. PPO Dental plans are PPO plans that offer you a broader network of dentists that you can receive dental care from. PPO Dental plans also allow enrollees to pay less when seeing a dentist or a dental care provider from the plan’s network.

The advantages of PPO dental plans include the following:

Our plans include but are not limited to:

PPO Dental plans are great for people who want more flexibility regarding their dental care. PPO Dental plans offer enrollees a much wider range of dentists and dental practices to choose from, meaning that you can choose from some of the best dentists available.

PPO Vision

PPO Vision plans pay a portion of your basic, preventative care like vision tests, contacts, eyeglass lenses, eyeglass frames, and lens protection for glasses. These plans are similar to PPO dental plans.

Some vision plans can also offer additional coverage services like discounts on corrective eye surgery like LASIK and disposable contact lens coverage. To get a clear idea of what we provide with our vision plans, it’s best to speak to us directly.

Any and everyone can benefit from vision cover, especially since eye exams are beneficial in detecting hidden or underlying medical problems. Even if you have perfect vision, it’s still good to know your options and prepare your eyes for your older years.

Our PPO Vision includes but is not limited to the following:

Any Exclusions and Limitations will be explained during your free consultation!

People with poor vision, a family history of poor vision, or eye diseases benefit most from PPO vision plans. Although we don’t usually recommend people with healthy vision get vision insurance, we recommend people who need corrective lenses or other visual aids to consider looking into vision insurance.

Life Insurance

Life insurance is an integral part of every household, and it allows family members to care for their loved ones after they’ve passed. 

There are many life insurance policies to choose from, including term, return of premium, and whole life.

With term life, you can select a term period that if the insured passes away during that period, they will receive the face amount of the policy. Their policy will expire if they outlive the policy term period unless the policy is converted to a whole-life policy. (This option is also the cheapest way to get insured while having a large face amount.)

Return of Premium works exactly like a term policy, except if you outlive the term, you will get your money back plus roughly 10% interest, depending on the company. 

Whole Life policies are permanent plans that don’t expire, and their cash value continues to increase with compound interest and with dividends in some cases. You can also borrow from the accrued value of your Whole Life policy.

Whether you’re building a family or want to leave something for your kids after you’ve passed, life insurance is a great option for anyone looking to secure the future of their loved ones and family.

Hopefully, this has clarified what to expect when it comes to all the different types of insurance out there.

While choosing can seem a little daunting, speaking to an insurance provider helps make the entire process much simpler, clearer, and smoother.

If you’re interested in learning more about any of the insurance products above, our team would love to help you make the best decision for your needs. 

Speak to our team today, and we’ll get you the coverage you need!