How to Find Affordable Health Insurance: Advice From medicaid-guide.org

The team at medicaid-guide.org realizes that many households cannot afford to purchase private insurance while also having incomes that disqualify them from obtaining government-funded health insurance like Medicaid. While Medicaid can support low-income households, some that marginally exceed the minimum annual salary that Medicaid demands for qualification are left with seemingly little aid. However, the U.S. requires all citizens to have access to health insurance. Additionally, citizens without health insurance pay, on average, twice as much as citizens with coverage. The health insurance Marketplace contains various insurance options that may benefit citizens on strict budgets. Although these other insurers may not subsidize all out-of-pocket costs citizens incur, some insurance plans remain affordable for citizens. It is important that everyone knows all of their health insurance options to find a plan that best suits their medical and financial needs.

Preferred Provider Organization (PPO)

This Marketplace insurance plan focuses on flexibility. Those insured through a PPO plan have the freedom to choose their own health care providers, visit specialists without referrals and receive care with out-of-network doctors. However, the team at medicaid-guide.org encourages patients to remain within their insurer’s network to ensure reduced premiums and co-pays. While PPO plans are cheaper than some other forms of insurance, they may require patients to pay medical fees in full and ask patients to apply for reimbursements rather than covering costs directly. This health insurance plan is beneficial for those needing frequent specialist appointments and for families that seek extra control over their health care.

Point of Service (POS)

Similar to PPO plans, people insured through a POS plan have cheaper premiums if they receive medical care with a network physician. However, POS plans assign network doctors to serve as the insured’s primary care physicians (PCPs). Due to network agreements, POS plans will not cover medical services provided by out-of-network doctors unless the PCP signs a referral explaining the patient’s reason for leaving the network. Most medical costs are covered under POS plans, and patients do not pay deductibles. Since POS plans may not be offered in all locations, the team at medicaid-guide.org recommends checking your local insurance Marketplace for insurance plan listings.

Health Maintenance Organization (HMO)

HMO plans limit patients to in-network physicians except in emergency situations, and HMO plans also designate in-network PCPs. While patients are restricted to using in-network providers, HMO plans only accept patients from certain areas within the HMO jurisdiction. This reduces the likelihood of patients needing out-of-network care. Despite the restrictions HMO plans enforce, HMO plans are one of the most affordable insurance plans available that focus on integrated and preventative care. The team at medicaid-guide.org reminds patients that HMO plans offer cost-share or co-insurance opportunities as well.

Exclusive Provider Organization (EPO)

Patients insured through EPO plans do not need a PCP or specialist referrals. However, patients must remain with the EPO plan’s network for all care. If patients choose to receive care from an out-of-network physician, their EPO plans will not cover any costs. The team at medicaid-guide.org encourages you to first research the providers within the plan’s networks.