4 Types of Health Plans: How They Compare
Point-of-Service Plan (POS) continued...
What doctors you can see. You can see in-network providers your primary care doctor refers you to. You can see out-of-network doctors, but you'll pay more.
What you pay:
- Premium: This is the cost you pay each month for insurance.
- Deductible: Your plan may require you to pay the amount of a deductible before it covers care beyond preventive services.You may pay a higher deductible if you see an out-of-network provider.
- Copays or coinsurance: You will pay either a copay, such as $15, when you get care or coinsurance, which is a percent of the charges for care. Copayments and coinsurance are higher when you use an out-of-network doctor.
Paperwork involved. If you go out-of-network, you have to pay your medical bill. Then you submit a claim to your POS plan to pay you back.
High-Deductible Health Plan With or Without a Health Savings Account
You may be able to pay less for your insurance with a high-deductible health plan. With an HDHP, you may have:
- One of these types of health plans: HMO, PPO, or POS
- Higher out-of-pocket costs than many types of plans, but if you reach the maximum out-of-pocket amount, the plan pays 100% of your care
- A health savings account (HSA) to help pay for your care. The money you put in an HSA is not taxed and can be used tax-free on eligible medical expenses.
W hat doctors you can see . This varies depending on the type of plan -- HMO, POS, or PPO
What you pay.
- Premium: An HDHP has the lowest premium compared to other plans.
- Deductible: The deductible is high – in 2015, deductibles for individual health plans range between $1,300 and $6,450 for one person or between $2,600 and $12,900 for a family. Like with HMOs and PPOs, your preventive care is free even if you haven't met the deductible.
- Copays or coinsurance: You must review your plans benefits carefully to learn what you will pay when you go for medical care.
With an HDHP, your out-of-pocket spending is capped. For instance, if you have insurance only for yourself, the most you have to spend in a year is about $6,450, not including premiums. If our insurance plan is for your family, the most you have to pay in a year is about $12,900 without premiums. The totals include your deductible. If you reach this amount, the plan pays 100% of your care.
Paperwork involved. The amount of paperwork varies, depending on whether you get care from a PPO, HMO, or POS plan. Keep all your receipts so you know when you've met your deductible.