Health insurance can be a complex topic, and while many people recognize its importance, few truly understand how it works. At Health Plans of America, we aim to simplify the process and help you better grasp the basics of health insurance.
First, it’s essential to know that depending on the type of health insurance you have, costs are handled in different ways. The insured may pay out-of-pocket, receive reimbursement, or the insurer may directly pay the healthcare provider.
There are two primary categories of health insurance: private and public (government-funded).
- Private Insurance: This is the most common form of health insurance, typically offered through employers or purchased individually.
- Public (Government) Insurance: These plans are funded by federal, state, or local governments to provide coverage for those who qualify.
Within these categories, there are various organizations that manage medical care for the insured. Two common types are:
- Health Maintenance Organization (HMO): This plan often offers the most affordable coverage. It requires you to visit a primary care physician for referrals and utilizes negotiated fees with providers to keep costs low.
- Preferred Provider Organization (PPO): This plan offers greater flexibility, allowing you to visit any doctor you choose without needing a referral. It still uses negotiated rates with providers but offers more freedom in choosing healthcare professionals.
If your employer or union offers health insurance, that can be an excellent option. However, many individuals remain uninsured.
Whether you’re purchasing health insurance for the first time or switching plans, Health Plans of America is here to help. We provide the tools and resources to make the insurance process easy and stress-free.