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Types of Health Insurance Plans

No matter the type of insurance plan that you choose, you need to make sure you have the knowledge of the exclusions and limitations before you sign up for the plan. By investigating these aspects of your plan you will eliminate any undesirable circumstances.

Health insurance plans can range in a variety of options and offers the consumer a multitude of choices. At times it can be cons fusing to find what you needs and what best reflects what you want. Let us help you go through each plan and give you in-depth information of the difference between each plan. We want to help you make the best decision while choosing your insurance plan

Medical plans are offered to individuals and groups. Within these tow brackets, there are different plans and options offered including:

Indemnity Plans

Indemnity plans takes a traditional approach to health insurance. It is knownas a fee for service plan while it allows you to choose what doctor or hospital you desire without restrictions. Many times, the insurer pays an up front deductible before the benefits become active at a 80/20 rate. 80% of the medical costs are paid by the insurance company and 20% by the insurer up to a certain budget and then after that it is covered 100% by the insurance company.

Preferred Provider Organization (PPO)

A preferred provider organization also known as a PPO is a insurance plan that allows the insurer to choose from a large network of physicians, hospitals, and medical providers. Benefits are provided no matter what medial provider you choose but if you choose a provider within your PPO network, the benefits will be much more comprehensive. You will not need a primary care physician or get referrals to see a specialist. At times, you will need to get pre-authorization to see hospitals or certain medical facilities.

PPOs will often offer doctor office co-payments, a prescription drug card, and wellness visits. Insurance companies usually negotiate discounted fees from the network providers and give these discounts to the insurer.

Health Maintenance Organization (HMO)

Health Maintenance Organizations (HMOs) is a type of insurance plan that has more restricted coverage. HMOs often have a smaller network of health care providers than the network the PPO plans have. You must chose a primary care physician in order to receive treatment. will normally include a much smaller network of providers than a PPO. You also need to get referrals to see a specialists. There are two forms of HMOs.


Point Of Service (POS)

plans have benefits similar to both the HMO and the Indemnity Plan. Premiums for this plan are usually higher than the HMO plan. For in-network care, a primary care physician needs to be choosen before benefits are applied. Out-of-network benefits are provided to insured individuals who choose to visit a doctor other than their PCP without a referral. You can see an out of network doctor but you will most likely have to pay an up-front deductible similar to an indemnity plan (fee for service cost). In-network benefits such as routine wellness visits are are covered but not covered if you go out of network.


Health Savings Account (HSA)

Health savings accounts were established for people who have a high-deductible medical insurance policy and open an tax-dedubtible health savings account. The insurer makes tax-deductible constibutions to their HAS and then to pay for medical bills, they withdraw the money from their accoutnt. The deposits made to the HAS are tax deductible and the insurer as control over the funds. If the insurer did not use all the funds in the account, the insurer would be able to use these funds to cover other medical needs including dental, medical, or prescriptions.

If you would like more information on the health insurance plans we offer, contact us for an individualized consultation with our experienced and qualified insurance agent in Denver, Eric Smith. We will evaluate your needs, or financial availability and provide you with plans that meet your wants. Let us help you get the benefits you deserve at an affordable cost. Serving the area of Denver, Colorado and all cities nearby.