Broker Check

Health Insurance Plans Available on the Marketplace

Health Insurance Plans Available on the Marketplace

There are different types of Marketplace health insurance plans designed to meet different needs. Some types of plans restrict your provider choices or encourage you to get care from the plan’s network of doctors, hospitals, pharmacies, and other medical service providers. Others pay a greater share of costs for providers outside the plan’s network. Here is an overview of the types of marketplace plans available to you.

Types of Marketplace plans

 

Depending on how many plans are offered in your area, you may find plans of all or any of these types at each metal level – Bronze, Silver, Gold, and Platinum.

Some examples of plan types you’ll find in the Marketplace:

  • Exclusive Provider Organization (EPO): A managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan’s network (except in an emergency).
  • Health Maintenance Organization (HMO): A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.
  • 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. POS plans require you to get a referral from your primary care doctor in order to see a specialist.
  • Preferred Provider Organization (PPO): A type of health plan where you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost.

For more information about the different options visit with one of our agents to discuss your specific situation.

 

There are pro’s and con’s for each option. It’s important to select the right option based on your needs. Contact us for guidance in selecting the right policy for you and your family. There is no cost to you for our help.

The opinions expressed in this material are for general informational purposes and should not be considered a solicitation for the purchase or sale of any products.  The information contained in this article was developed from sources believed to be accurate.  This material is not intended as tax or legal advice.  It may not be used for the purpose of avoiding any federal tax penalties.  Please consult legal and/or tax professionals for specific information regarding your individual situation.  For more complete information please access the government website www.healthcare.gov.  AGE-6766686.1 (7/24)(Exp. 7/26)