If Health Insurance Plans Were Diets

The diet industry offers at least as many options as the healthcare industry, and just like different diets work for different people, the health insurance plan that’s right for you may not be right for someone else. But with so many different kinds of health insurance plans available, things can get pretty confusing.

In-network doctors, out-of-network doctors, copays, premiums, deductibles…how can you keep it all straight? HealthMarkets Insurance Agency wants to help you out, so we’ve provided you with this handy guide to insurance plans.

Health Management Organization (HMO) Plan

Having an HMO plan is like going on the Subway Diet. Remember Jared, who lost a lot of weight by eating 6-inch subs for every meal? It’s the perfect diet if you love Subway. With an HMO, you choose a primary care physician (PCP), and that’s who you see for all of your medical needs. If you want to go to a specialist, you need to get a referral from your PCP. This plan focuses on preventive care, so if you get regular checkups, or if you love your doctor, it could be a good choice for you. If you already have a PCP, make sure that he or she is in-network. If you want to ‘cheat on’ your primary care physician and see an out-of-network doctor, you may be footing the bill.

Preferred Provider Organization (PPO) Plan

The Preferred Provider Organization, or PPO Plan, is kind of like being on Weight Watchers. You aren’t stuck eating one type of food every day, but your options are still limited. Every food has a certain number of ‘points,’ and you’re only allowed to eat a target number of ‘points’ per day. So, theoretically, you can eat pretty much whatever you want, but some foods ‘cost’ more than others.

In a Preferred Provider Organization, you can use an out-of-network doctor, but that’s like eating a chocolate donut while you’re on Weight Watchers. It’s possible, but it costs more. You can use any in-network doctors you want, and you don’t need referrals to see a specialist. A PPO gives you more freedom than an HMO, but you’re still limited to in-network doctors, unless you want to pay the fee for going out of network.

High Deductible Health Plan (HDHP)

A High Deductible Health Plan may be a good choice for healthy people who don’t anticipate any illnesses. It’s similar to a Minimalist Diet where you reduce food down to only what is essential.

A High Deductible Health Plan is a great choice, as long as you don’t get sick. This isn’t the best option for those with medical conditions or hypochondriacs who regularly see a doctor. With an HDHP, you pay lower monthly premiums. If you do have to go to the doctor or the hospital, you pay a higher deductible. Like someone on a minimalist diet, you hope that by staying healthy, you will only need a minimal of healthcare services.

We hope that we have cleared up some confusion about the different types of health insurance plans, and maybe even inspired you to try a new diet. If you have any questions about health insurance, call your local HealthMarkets agent today. We’ll walk you through the process and help find the best plan for you, at no cost to you.


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