Health plan

From WikiMD's Food, Medicine & Wellness Encyclopedia

Health plan is a type of insurance that covers medical expenses for individuals. These plans can be purchased by individuals or provided by employers. They can also be part of government programs such as Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and the Veterans Health Administration.

Types of Health Plans[edit | edit source]

There are several types of health plans, including:

  • Fee-for-service (FFS): This is a traditional type of health insurance where the health plan will either pay the medical provider directly or reimburse you after you have filed an insurance claim for each covered medical expense.
  • Health Maintenance Organizations (HMOs): These are organizations that provide health care for their members through a network of doctors, hospitals, and other healthcare providers.
  • Preferred Provider Organizations (PPOs): These are health plans that have a network of providers who agree to provide care for members at lower costs. They also allow members to see out-of-network providers at a higher cost.
  • Point of Service (POS): These are health plans that are a hybrid of HMO and PPO plans. They require you to choose a primary care physician and get a referral to see a specialist.
  • High Deductible Health Plans (HDHPs): These are insurance policies with higher deductibles but lower premiums. These may be combined with health savings accounts that allow individuals to pay for certain medical expenses with pre-tax money.

Choosing a Health Plan[edit | edit source]

When choosing a health plan, it's important to consider:

  • Cost: This includes premiums, deductibles, copayments, and out-of-pocket maximums.
  • Coverage: This includes the types of services that are covered, from preventive care to specialist visits to prescription drugs.
  • Provider Network: This includes the doctors, hospitals, and other healthcare providers that are part of the plan.
  • Quality of Care: This includes the quality of care provided by the doctors and hospitals that are part of the plan.

See Also[edit | edit source]

Health plan Resources
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Contributors: Prab R. Tumpati, MD