Health insurance helps cover medical expenses by paying a portion of your healthcare costs in exchange for monthly premiums. Understanding the basics can help you make informed decisions about your coverage.
Types of Health Insurance Plans
HMO (Health Maintenance Organization): Requires you to choose a primary care physician and get referrals for specialists. Lower premiums but less flexibility.
PPO (Preferred Provider Organization): Offers more flexibility to see any provider, with lower costs for in-network doctors. Higher premiums but no referral needed.
EPO (Exclusive Provider Organization): Similar to PPO but doesn't cover out-of-network care except in emergencies.
HDHP (High Deductible Health Plan): Lower premiums with higher deductibles. Can be paired with a Health Savings Account (HSA) for tax advantages.
Key Terms to Know
- Premium: Monthly payment to maintain coverage
- Deductible: Amount you pay before insurance kicks in
- Copay: Fixed amount for specific services (e.g., $30 for a doctor visit)
- Coinsurance: Percentage you pay after meeting your deductible
- Out-of-pocket maximum: The most you'll pay in a year before insurance covers 100%
How to Choose the Right Plan
Consider your health needs, budget, preferred doctors, and medications. If you're generally healthy, an HDHP with HSA may save money. If you need frequent care, a PPO or HMO with lower copays might be better despite higher premiums.
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Written by the Ensureing Team
Updated March 2026 · 4 min read