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“Take the guesswork out of getting the right kind of insurance coverage with help from an independent agent.”
Medical treatments are expensive, but without health insurance, they could end up costing you for the rest of your life.
Tanya Garza Insurance Advisors can help you find an affordable healthcare plan that’s right for you. Call now to get a free quote!
Knowing Your Health Coverage Options
There are four main types of health insurance for Georgia residents to choose from: EPO, HMO, POS, and PPO.
Health insurance plans like these help pay for your medical, surgical, and hospital expenses. These plans not only cover your medical needs but also cover your dental expenses, mental health services, and prescription drugs, depending on the coverage you choose.
- Exclusive Provider Organization (EPO): A health insurance plan that only allows you to get health care services from doctors, hospitals, and other care providers that are within your network. You’ll have to pay for anything you get from going to someone outside the network. Your insurance won’t cover it, except in emergencies. A defining feature of EPOs is that you do not need a referral if you want to see a specialist with EPO insurance.
- Health Maintenance Organization (HMO): A type of health insurance plan that limits coverage to care provided by doctors who work for or contract with the HMO. It doesn’t cover out-of-network care unless you have an emergency or a life-threatening situation. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs are often integrated with care, and they tend to have a preventative care focus.
- Point of Service (POS): A type of plan where you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. If you want to see a specialist, you need to have a referral from your primary care physician.
- Preferred Provider Organization (PPO): A type of health plan where you can use providers in the plan’s network at reduced rates. You can use doctors, hospitals, and other providers outside of the network without a referral for an additional cost. PPO plans are more comprehensive in their coverage and offer a wider range of providers and services than HMOs.
Understanding Common Health Insurance Terms
Understanding health insurance lingo is one of the first things you should do when talking to your insurance agent about your coverage. Below are the most common health insurance terms:
- Deductible — This is an amount you’re required to pay toward medical bills prior to your health care insurance coverage.
- Co-pay — the amount you have to pay upfront for doctor’s visits and prescription refills.
- Co-insurance — the percentage of your medical bills that you are responsible for paying after meeting your deductible.
Learn more about health insurance by talking to an insurance advisor today.