What Different Types of Health Care Are There? And What kind of health care is covered by your plan?

There are several different types of health care out there, so of course there will be differing amounts of coverage for different kinds of care.

Some procedures are In Network vs. some that are Out of Network. So when it comes to differing health care and different insurance plans, what do you need to know?

Some plans have higher deductibles, and some are called “catastrophe” plans. But what the heck does any of that really mean?

The breakdown is as follows:

EPO (In Network): Services covered ONLY if the Doctor or Hospital is in the listed Network.

PPO (No Referral Necessary): PAY LESS if Doctor/Hospital in Network. If you go out of Network the services will still be covered, they will just cost more. Again don’t need a referral for out of Network.

POS (Need a Referral): PAY LESS if Doctor/Hospital in Network. If you go out of Network you need a referral from your Primary Care Doctor for a Specialist.

HMO: More limited Network. The Doctor or Hospital is usually limited to those who have a contract with HMO.

“Catastrophe” Plan: Very High Deductible. Usually for those who never go to the doctor. Allowed 3 free wellness checks a year. Anything else is not covered until you meet your deductible. The cost of the plan itself is much cheaper, but the deductible is very high. These are protection for “worse case scenarios”

*Please note that in the case of an emergency you will be considered In Network with any hospital. This is good because your life may depend on going to a hospital where you wouldn’t usually have coverage.

This blog was written by Stephanie Haltiner, a Health Insurance Specialist.

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