Pin It

Different Options For Individual Health Plans

A quick online search for health plans results in over twenty-one million results. This number is staggering, and it leads to a lot of confusion for individuals in West Orange, NJ, looking for information on individual health plans.

An individual health plan is one that a person purchases for their own coverage. In other words, the health plan is not purchased and provided through your employer, and it is not part of a government program such as Medicare or Medicaid. The individual health plan may be an option for a person to consider if they retire before Medicare edibility, work at a company that does not offer health benefits, or are self-employed.

Types of Plans

There are several options to choose from when shopping for individual health plans in West Orange, NJ. Considering the short and long-term costs of any health plan takes time and the willingness to compare deductibles, copays, and the plan’s limitations based on your current health care requirements and any known future concerns.

The four common types of individual health plans include:

  • Health Maintenance Organization (HMO) – all services are provided through a network of facilities and medical professionals. Referrals to specialists are required by primary care doctors (PCPs).
  • Preferred Provider Organization (PPO) – no referrals required to see specialists, greater choice of providers, increased cost if seeing out-of-network doctors.
  • Exclusive Provider Organization (EPO) – no referrals for specialists, but patients must pay for all costs associated with seeing providers outside of the network unless it is an emergency
  • Point-Of-Service Plan (POS) – choice of providers is larger than with an HMO, but a PCP must make a referral to specialists.

Individuals under the age of thirty in West Orange, NJ, can also choose a catastrophic plan offering limited coverage and a higher deductible.