Health Insurance Types 2020 | The 4 Types of Health Insurance

Looking for what Health Insurance Types are available to you in 2020?

Here are the 4 types of health insurance plans explained:

1. Health Maintenance Organizations (HMOs) | 0:25
In the United States, a health maintenance organization is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis. Employers with 25 or more employees are required to offer federally certified HMO options if the employer offers traditional healthcare options. Unlike traditional indemnity insurance, an HMO covers care rendered by those doctors and other professionals who have agreed by contract to treat patients in accordance with the HMO’s guidelines and restrictions in exchange for a steady stream of customers. HMOs cover emergency care regardless of the health care provider’s contracted status.

2. Fee for Service (FFS) | 1:06
Fee-for-service is a payment model where services are unbundled and paid for separately. In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care rather than the quality, therefore it can largely raise costs. FFS is the dominant physician payment method in the United States.

3. Preferred Provider Organizations (PPOs) | 1:25
PPO is your in-between option of HMOs and FFS. PPO is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at reduced rates to the top insurer’s or administrator’s clients.

4. Point of Service | 1:56
A point of service plan is a type of managed care plan that is a hybrid of HMO and PPO plans. Like an HMO, participants designate an in-network physician to be their primary care provider. But like a PPO, patients may go outside of the provider network for health care services. When patients venture out of the network, they’ll have to pay most of the cost, unless the primary care provider has made a referral to the out-of-network provider. Then the medical plan will pick up the tab.

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