Most Americans get their health insurance coverage through their employer. However, if your employer’s plan is limited or you are not eligible for an employer-sponsored health insurance plan, the Affordable Care Act (ACA) is a great way to get coverage. You can’t get denied health coverage for an ACA plan.
There are many different types of Affordable Care Act plans, but once you understand the types of ACA, everything will be less overwhelming. Now, let’s take a look at the types of ACA plans.
PPOs (Preferred Provider Organization Plans)
PPOs are one of the most popular types of ACAs plans. Preferred Provider Organization plans offer a large network of providers, so you have a lot of hospitals, doctors, and other healthcare specialists and facilities to select from. You are not required to choose a Primary Care Provider (PCP) with this type of ACA plan, and you can see any specialists without referrals.
However, while you can choose to see health providers outside of the PPOs network, you will be required to pay more out-of-pocket costs.
EPOs (Exclusive Provider Organization Plans)
This type of health plan provides you with a network of participating health providers to select from. Most EPO plans don’t provide coverage for out-of-network services unless it’s an emergency. Depending on the EPO plan you choose, you may be required to choose a PCP. However, you don’t need a referral from a primary care provider to see a specialist in your network.
HMOs (Health Maintenance Organization Plans)
This type of ACA plan offers a broad range of healthcare services that are offered through a network of providers. Members will most likely have coverage for a wide range of preventative services than they would through other ACA plans. The plan will require you to choose a primary care physician who will manage most of your healthcare needs. Your primary care physician will also need to refer you to a specialist when required.
The coinsurance and copays for an HMO plan are usually lower than the others as far as you stay in the network. Keep in mind that you won’t have coverage for any care you receive outside of the services or care you receive without a referral from your PCP.
POSs (Point of Service Plans)
POS combines the features of Preferred Provider Organization Plans and Health Maintenance Organization Plans. Similar to an HMO plan, you will be required to choose a primary care provider. Usually, the services you receive through your PCP are not subject to a deductible. Also, just like a PPO plan, a POS plan allows you to receive care out of the provider’s network, but it comes with greater out-of-pocket costs. Besides, you may be responsible for paying coinsurance, copay, or annual deductible.
If you need help choosing an ACA plan that will be perfect for your health needs and budget, contact Veritas Insurance Group to speak with an experienced insurance agent that can help explore your options.
