Care health insurance is a managed care plan that contracts with doctors and other providers to offer its members discounts on services they use, as well as may requiring deductible payments, copayments or coinsurance payments from members.
There are four categories of health insurance policies: Bronze, Silver, Gold and Platinum. Each offers distinct costs and benefits.
Major medical plans
Care health insurance provides major medical plans that comply with the requirements of the Affordable Care Act (ACA) for qualifying coverage, both through the Marketplace and directly from an insurer. Individuals can select their perfect major medical plan during open or special enrollment – often featuring deductible payments required before coinsurance begins covering costs; in some instances coinsurance may cover part or all of these costs after your deductible has been met.
These plans typically contain a maximum out-of-pocket limit that caps annual out-of-pocket expenses to protect from overspending, and include doctors, hospitals and medical facilities within their network. You can find a plan that meets your needs using the Marketplace to compare prices and benefits; alternatively you could purchase one off exchange from licensed private brokers. In either instance, The Marketplace will walk you through all the available options to determine whether you qualify for premium or cost-sharing subsidies.
Fee-for-service (FFS) plans
FFS plans do not feature provider networks, giving you greater freedom in choosing any physician you desire. Although more expensive than PPO and HMO options, FFS plans offer unparalleled freedom and independence; no referral will be needed when visiting specialists.
Typically, insurance companies either directly pay your healthcare providers or reimburse you after filing a claim form with them. Some require filing an official claim form while others simply require you to submit receipts as evidence of payment. While this approach can be more costly and involve more paperwork, it does provide greater freedom when selecting healthcare providers of your own choice.
These plans are also flexible and have no upper age limit for policyholders, making them suitable for older adults as well as those who do not like paying upfront for healthcare costs like diabetes and heart diseases. Furthermore, these plans offer peace of mind to anyone living with chronic medical conditions such as diabetes and heart diseases.
Point-of-service (POS) plans
POS plans combine the benefits of PPO and HMO plans. They usually offer lower out-of-pocket expenses for services provided within their network while still permitting members to see providers outside their network with prior authorization from their primary care doctor (PCP). Unfortunately, however, many POS plans require PCPs as care coordinators which could present challenges for some patients.
POS plans are built on managed care principles of lower medical costs in exchange for limited choices. While PPO plans typically offer low premiums, POS health insurance plans generally require beneficiaries to meet a deductible before coverage starts; and beneficiaries of POS health insurance must file and complete paperwork related to out-of-network care themselves. eHealth can assist you with finding affordable POS health insurance options so get started today – we make it simple!
Short-term plans
Short-term plans provide short-term health coverage at an economical price. Ideal for filling gaps in coverage or covering expenses not covered by traditional plans such as maternity care or prescription drugs, short-term plans tend to have higher deductibles as well.
Before Trump took office, federal regulations limited short-term plans to three months; however, under his regime this has changed to six months. Furthermore, certain states have also passed laws restricting short-term policies’ duration.
After millions of Americans lost their jobs and employer-sponsored insurance (ESI) coverage during COVID-19’s pandemic, many turned to short-term plans for coverage. Since these plans do not follow the same requirements as ACA-compliant marketplace plans or employer plans, it’s essential that buyers understand exactly what these short-term plans offer before buying one – this GAO report contains our knowledge regarding these plans.
