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10 Things To Check When You’re Enrolling in Health Insurance

GOBankingRates Logo By Cynthia Measom of GOBankingRates | Slide 4 of 11: Not only do you need to check on the levels of plans and how well each plan level would meet your care needs, but you also should check on benefit design. In the Affordable Care Act marketplace, the most common benefit designs are health maintenance organization, exclusive provider organization and preferred provider organization — also known as HMOs, EPOs and PPOs, respectively.  It’s important to note that HMOs and EPOs do not pay for care you receive outside of your provider network. In contrast, while PPOs are generally more expensive, they do not require referrals to see a specialist. Additionally, PPOs do allow covered out-of-network care, although it will likely be at a higher price than in-network care. More: What Is an HSA and Why Do You Need One?

Benefit Design

Not only do you need to check on the levels of plans and how well each plan level would meet your care needs, but you also should check on benefit design. In the Affordable Care Act marketplace, the most common benefit designs are health maintenance organization, exclusive provider organization and preferred provider organization — also known as HMOs, EPOs and PPOs, respectively.  It’s important to note that HMOs and EPOs do not pay for care you receive outside of your provider network. In contrast, while PPOs are generally more expensive, they do not require referrals to see a specialist. Additionally, PPOs do allow covered out-of-network care, although it will likely be at a higher price than in-network care.

More: What Is an HSA and Why Do You Need One?

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