In the United States, there are several different types of health insurance coverages solicited to an array of different demographics. From personal coverages offered from employers and private entities (i.e. Blue Cross and Blue Shield), to public health insurance options- most notably, Medicare and Medicaid- accessible from Government, it is important to know what health insurance best fits. More importantly, for someone between ages 62-65, it’s crucial to be aware of these options before the transitional process into Medicare comes into effect.
Whether nearing retirement, on a source of fixed income, or even self-employed, chances are those in the “55 and up club” have some sort of health insurance packaging they receive or pay into. In regards to private health insurance, some employers only offer one type of service plan; others, however, may allow you to choose from more than one plan. In general, buying health insurance on your own, instead of getting a plan through an employer, tends to cost more. Instead of sharing the healthcare costs with an employer, you pay for the plan yourself. Some insurance plans work with certain health care providers and facilities, which are part of the plan’s given network, providing care at lower costs, a process known as managed care.
There are different kinds of managed care plans. As stated by Online Publisher WebMD, one can choose between two main types of private insurance plans: Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs).
Health Maintenance Organizations, while usually only paying for medical care within their network of healthcare providers, do provide less cost than plans offering a wider range of providers. Although there isn’t as much flexibility, HMOs are well suited for those currently interested in only a handful of companies for their health needs.
Unlike HMOs, Preferred Provider Organizations (PPOs) allow for a greater choice of in-network providers for the price payed. Albeit the cost payed up front is greater, on average, HMOs provide much better value for those looking for healthcare options in the United States pre-Medicare compared to its PPO counterpart, so long as one sees a provider within that HMO’s network.
Another option worthy of mentioning is an Exclusive Provider Organization, or EPO. EPOs, much like HMOs, generally do not cover care outside of the designated plan provider’s network. As stated in an article by the Washington Post, one specific benefit with EPOs, however, is not necessarily needing a referral whenever seeing a specialist.
Of course, the other primary source of healthcare provision is public (Government) insurance- Medicare and Medicaid. While the latter of which is only available to low-income families and individuals, Medicare opens up as soon as one reaches 65 years of age (unless certain disabilities or health problems (such as kidney failure with dialysis) occurs.
As with any type of health insurance coverage, knowing each type of managed care plan is essential for choosing the best one for your needs.