Types of Health Insurance | MetLife (2024)

There’s a lot to consider when choosing a health insurance plan. Generally, the decision comes down to your current medical needs, how much you’re willing to spend, and what expenses you need covered. Ahead, get a better idea of what some of the most common insurance plans have to offer.

HMO

One of the most common health insurance options is a health maintenance organization or HMO. This type of insurance provides medical services via a network of physicians, hospitals, and healthcare providers.1

With an HMO plan, you’re required to seek medical services within the existing network. HMOs typically don’t offer out-of-network coverage. If there’s an emergency, and you receive medical services at an out-of-network hospital, an HMO plan typically covers those expenses at in-network rates, but you can still be charged by non-participating doctors who treat you at that facility.

HMO participants choose a primary care physician for basic healthcare needs. This physician is responsible for coordinating healthcare services, and ensuring that any specialist is within the plan’s network. Under an HMO, you typically need a referral from your primary care physician to see one of these specialists.

PPO

Another common type of health plan is preferred provider organizations or PPOs. Much like HMOs, PPOs come with an approved network of healthcare providers.

Unlike HMOs, PPOs often provide coverage for medical services rendered outside of the network. However, you should expect to pay more out-of-pocket costs than you would if you stayed within your plan’s network of approved physicians.2

PPOs don’t require you to choose a primary care physician and may allow you to see a specialist without needing a referral. This added flexibility in choosing healthcare providers does come with a cost. PPOs typically include higher monthly premiums than HMOs.

EPO

An exclusive provider organization or EPO, offers a network of doctors and hospitals to choose from. They typically have lower monthly premiums than PPO plans but have more restrictions. Out-of-network coverage is only covered for emergencies, for example.

In addition to lower copays and deductibles, EPOs don’t always require you to establish a primary care physician, and you can see in-network specialists without a referral.

POS

A point of service plan, or POS, is a type of health insurance plan that requires you to choose a primary care physician. Generally, a primary care physician coordinates your healthcare within the approved POS network, and specialist referrals are required.

You still receive some coverage if you visit an out-of-network physician, but you’re subject to a deductible and higher upfront cost. Under a POS, you typically pay less in monthly premiums than you would with a PPO.

How to pick your health insurance

Choosing the “best” type of health insurance all comes down to what works for you. There are no one-size-fits-all solutions when it comes to choosing a health plan but considering your personal healthcare needs can provide some clarity.

For example, if you have a preexisting condition or require ongoing treatment, you might want a plan with more extensive and flexible coverage. If you’re a relatively healthy person, you may decide a plan with lower monthly insurance premiums is the best choice.

The number of dependents you have also plays a significant role when deciding on types of medical insurance. If you have young children or elderly family members in your care, you may want a plan that covers pediatric or long-term geriatric care.

In short, there are benefits and drawbacks regardless of which plan you choose. So it’s a good idea to take a close look at your own needs and budget restrictions before making this important decision. With the right type of insurance, you can rest easy knowing you and your loved ones have their healthcare needs covered.

Types of Health Insurance | MetLife (2024)

FAQs

What are the 2 most common health insurance plans? ›

Ahead, get a better idea of what some of the most common insurance plans have to offer.
  • HMO. One of the most common health insurance options is a health maintenance organization or HMO. ...
  • PPO. Another common type of health plan is preferred provider organizations or PPOs. ...
  • EPO. ...
  • POS.
Jun 12, 2023

What are the three 3 main types of insurance? ›

Although there are many insurance policy types, some of the most common are life, health, homeowners, and auto. The right type of insurance for you will depend on your goals and financial situation. Consumer Financial Protection Bureau.

What are the 4 most common insurance? ›

Most experts agree that life, health, long-term disability, and auto insurance are the four types of insurance you must have.

What are the top 3 health insurances? ›

Best Health Insurance Companies for 2024
  • Best Overall: Blue Cross Blue Shield.
  • Highest Quality Plans: Kaiser Permanente.
  • Most Health Management Programs: Oscar.
  • Best for Same-Day Care: Aetna CVS Health.

Is HMO or PPO better? ›

HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.

What is a PPO vs HMO? ›

Two popular types you'll frequently see are HMO and PPO. Differences between HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization) plans include network size, ability to see specialists, costs, and out-of-network coverage.

What types of insurance are not recommended? ›

15 Insurance Policies You Don't Need
  • Private Mortgage Insurance. ...
  • Extended Warranties. ...
  • Automobile Collision Insurance. ...
  • Rental Car Insurance. ...
  • Car Rental Damage Insurance. ...
  • Flight Insurance. ...
  • Water Line Coverage. ...
  • Life Insurance for Children.

What is the Big 3 insurance? ›

What are the three biggest life insurance companies in the U.S.? The three largest life insurance companies in the U.S., as per the latest data from the National Association of Insurance Commissioners (NAIC), are New York Life Group, Northwestern Mutual and Metropolitan Group.

What is the most basic form of insurance? ›

Basic Form

It typically covers damage or loss caused by specific perils, such as fire, lightning, windstorm, hail, explosion, and vandalism. This type of coverage is sometimes called “named perils coverage” because it only covers the perils named explicitly in the policy.

What is the most popular type of health insurance? ›

Here are the three most common types of health insurance plans along with what to consider for each.
  • HEALTH MAINTENANCE ORGANIZATION (HMO) ...
  • PREFERRED PROVIDER ORGANIZATION (PPO) ...
  • HIGH-DEDUCTIBLE HEALTH PLAN (HDHP) WITH A HEALTH SAVINGS ACCOUNT (HSA)
Sep 27, 2020

What is the most common type of private health insurance? ›

The preferred provider organization (PPO) plan is the most common health insurance coverage that employers offer. According to the KFF1, 49% of surveyed individuals with an employer-sponsored plan have a PPO.

What is the most common health insurance in the US? ›

Of the subtypes of health insurance coverage, employment-based insurance was the most common, covering 54.5 percent of the population for some or all of the calendar year, followed by Medicaid (18.8 percent), Medicare (18.7 percent), direct-purchase coverage (9.9 percent), TRICARE (2.4 percent), and VA and CHAMPVA ...

What is the most expensive health insurance? ›

Platinum health insurance is the highest-priced level of health insurance you can buy. You pay expensive monthly premiums. In exchange, you get a low deductible, out-of-pocket maximum, copays and coinsurance. A Platinum health plan will best fit you if you have serious or chronic health concerns.

What amount of health insurance is the best? ›

“It is recommended to opt for a sum insured of Rs. 10 lakhs or more, as this will provide sufficient coverage in the foreseeable future. Additional top-up covers that augment the sum insured are available at reasonable costs. It's important to note that nowadays, health insurance coverage can extend up to Rs.

Which health insurance covers all 50 states? ›

The Blue Cross and Blue Shield Association is a national federation of independent, community-based and locally operated Blue Cross and Blue Shield companies. Healthcare coverage is one of the most important decisions you make. Choose the card that opens doors in all 50 states.

Which type of health insurance is the most common? ›

The preferred provider organization (PPO) plan is the most common health insurance coverage that employers offer. According to the KFF1, 49% of surveyed individuals with an employer-sponsored plan have a PPO.

Why do doctors prefer PPO? ›

Doctors often prefer PPOs because they offer greater reimbursem*nt rates compared to HMOs and have less administrative paperwork. Is a PPO a good thing? For many, a PPO's flexibility and coverage make it a favorable choice, but it comes with higher premiums.

What type of health insurance is most common in the US? ›

Private health insurance is the predominant source of health insurance coverage in the United States.

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