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Key health plan ingredients

Updated: Nov 22, 2022

Most will agree that health insurance can be complicated and understanding it is not easy. Two key ingredients however that are important to any health plan whether individual or group coverage are Plan Type and Provider Networks. While not often talked about as these don’t have to do with deductibles or out-of-pocket limits, they can be just as important in determining which plan(s) may be right for you and your family. Plan Types: Common plan types include

  • HMO – Health Maintenance Organization

  • PPO – Preferred Provider Organization

  • EPO – Exclusive Provider Organization

  • POS – Point of Service

Different plan types have different requirements of members that are important to understand as they affect how the plan works.

Provider Networks Provider networks include physicians, clinics, outpatient facilities, imaging and lab centers, urgent care centers, hospitals of all types, and more.

It is very important to always check a plan’s provider listings to see if the doctors and hospitals you want to use are in network or not, as your costs to use out of network providers can often be much higher.

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