Best Group Health Insurance Plans NC

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Best Group Health Insurance Plan for You and Your
Family!
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HMO, PPO, HDHP, POS, EPO It is so hard to know
which Group Health Insurance Plan is best for you
and your family!
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All of those acronyms and who knows what they
mean!

• When trying to determine which choice is the best
  for you, you need to take the following factors
  into account
• How healthy are you and your family?
• Does your health care provider accept only
  certain insurance providers?
• Whats your current financial situation?
• Do you want to pay more upfront in premiums or
  later in coinsurance?
• Do you want flexibility in choosing your
  specialists?

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The answer to these questions will make choosing
an insurance option a little easier.

• Preferred provider organizations (PPOs)
• Health maintenance organizations (HMOs)
• High deductible health plans (HDHPs)
• Point of service plans (POS)
• Exclusive provider organization plans (EPO)
• The two most common health plans have been
  generally HMOs and PPOs, but HDHPs have become a
  lower-cost health insurance option for employers
  over the past decade. POS and EPO plans are
  options provided by some employers and health
  insurers, but theyre not nearly as common as
  HMOs, PPOs and HDHPs.
• Here are the Pros and Cons about each of the five
  plans that will help you make the right decision
  for your circumstances.

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What is an HMO?
HMO stands for health maintenance organization
and makes up 16 percent of health plans. It is
known for its lower premiums and restricted
network of doctors and hospitals, which means you
sacrifice flexibility for lower upfront
costs. HMO PROS Lower premiums Lower Cost
Than a PPO HMO CONS Need to stay in network
Need referral to see a specialist Youll likely
pay less in premiums for an HMO compared to a PPO
sometimes significantly less.
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Not all providers accept HMOs, so before choosing
an HMO, make sure your provider or providers
accept the plan. What kind of person should
choose an HMO Someone who wants to pay as little
as possible in premiums and not have to face high
deductibles. An HMO could be a good option if you
have a PCP and your other health care providers
are already in the HMO.
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What is a PPO?
PPO stands for preferred-provider organization.
Premiums and deductibles are usually much higher
for a PPO compared to an HMO, but that comes with
greater flexibility. PPO Pros Larger Network,
Can go out of network, Dont need a referral for
specialists PPO Cons Higher premiums Has a
deductible You usually dont have to select a
primary care provider (PCP) in a PPO plan, and
you can choose from more healthcare providers
than an HMO because PPO networks are usually
larger.
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PPOs allow you to get both in-network and
out-of-network care though out-of-network
providers will cost you more. You can also see a
specialist without a referral. In addition to
higher premiums, PPOs usually have a deductible
that you have to meet before the health plan pays
for care. What kind of person should chose a PPO
plan Someone who utilizes health care regularly
and sees specialists or wants to have the option
to see a specialist without getting a referral.
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What is an HDHP?
HDHP stands for high-deductible health plan.
HDHPs have grown in popularity as more employers
have started to offer the plans as a way to
contain health care costs. HDHP Pros Lower
Premiums, Employer-contributed HSAs HDHP
Cons Need to stay in network, Need a referral to
see a specialist. Unlike the other plans, an
HDHP can vary depending on the specific plan. For
instance, one HDHP could be very similar to an
HMO, while another could look more like a
PPO. The critical piece of a HDHP is the size of
the deductible and Health Savings Account that is
attached to it.
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The deductible is usually higher in an HDHP
compared to other plans. Youll want to keep that
in mind if you choose this plan, and you should
set aside money for the deductible in case you
need it. HDHPs typically feature a Health
Savings Account, which allows you to save money
pre-tax to pay for qualified medical expenses.
Some employers also contribute money into
employee HSA accounts to help pay for care. What
kind of person should opt for a HDHP Someone who
is healthy and doesnt expect to use many health
care services within the next year. You want the
cheapest premiums and dont mind having to pay a
high deductible if you need a lot of care.
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What is a POS?
POS stands for point of service plan and makes up
only 6 percent of health plans. POS plans are a
hybrid of PPO and HMOs. In fact, point of service
means that the health care consumer gets to
choose whether to use HMO or PPO services each
time you see a provider. POS Pros Dont need a
referral, Can go out of network for care POS
Cons Need to file claims if you go out of
network, higher deductibles than PPO and HMO
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POS plans usually have similar rules to HMOs (for
instance, you need to choose an in-network
physician as your PCP), but you can see an
out-of-network physician for a higher fee in a
POS plan. What kind of person should opt for a
POS Someone who likes being able to go out of
network for care, but also wants a PCP
coordinating your care.
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What is an EPO?
EPO stands for exclusive provider organization
and is a managed care plan that requires you to
go to doctors and hospitals in the plans
network. EPO Pros Dont need a referral EPO
Cons Need to stay in network for care, limited
network You dont need to choose a PCP or need a
referral, so in that sense, its similar to a
PPO, but you will only receive coverage for
providers in your network. Other parts of an EPO
plan are similar to an HMO, such as having a
limited network of doctors and hospitals. You
cant get care outside the network unless its an
emergency.
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Much like a PPO, you need to get approval from
your health plan in order to get whats deemed as
an expensive service. What kind of person should
opt for an EPO Someone who doesnt mind having a
limited number of doctors and facilities and
would rather not have to get a referral to see a
specialist. Choosing The RIGHT Group Health
Insurance Plans NC is Unique For Every Situation.
The Independent Benefit Advisors, serving Raleigh
The Triangle, Charlotte, and ALL of North
Carolina can help determine the plan that is best
for YOUR situation.
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Best Group Health Insurance Plans NC
Need more information about the cost of
Affordable group health insurance? Give
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