Personal Coverages | Health
Who Needs Health Insurance?
Types of Health Insurance Plans
HMO (Health Maintenance Organization)
What it is: Network-based care, often centered around a primary care doctor and referrals.
Best for: people who want lower costs and don’t mind a more structured network.
PPO (Preferred Provider Organization)
What it is: More flexibility and typically no referral requirement; out-of-network access may be available but usually costs more.
Best for: people who want flexibility and broader provider access.
EPO (Exclusive Provider Organization)
What it is: Network-based plan, usually without primary care/referral requirements; out-of-network care typically isn’t covered.
Best for: people who can stay in-network and want a simpler cost structure.
POS (Point of Service)
What it is: A hybrid approach that may allow out-of-network coverage through referrals from a primary care provider.
Best for: people who want some flexibility while keeping costs more controlled.
GAP plans
What it is: Supplemental coverage designed to help with high deductibles or unexpected medical costs.
Best for: people who want an extra safety net alongside major medical coverage.
Medicare
What it is: Federal coverage for seniors and certain qualifying disabilities, including Medicare Advantage and prescription drug plans.
Best for: Medicare-eligible residents who want help comparing options and avoiding gaps.
Types of Health Policies
Individual
Purchased privately for yourself or your family – common for self-employed, between jobs, or when employer coverage isn’t available.
Group
Employer-sponsored plans that may include dependent coverage, often with shared premium costs.
Medicare Supplements (Medigap)
Additional coverage to help fill gaps left by Original Medicare, like copays and deductibles (plan availability varies).
Real-World Scenarios
