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Health Insurance Terminology Bookmark this page Health Insurance Tips and Advice Center Topic: Health Insurance Terminology See the subtopics menu for definitions of common health insurance terminology. For additional information about health insurance, see the topic list directly below. Health Insurance Topics · Choosing Health Insurance · Health Insurance Explained · Health Insurance Terms Health Insurance Terminology - Subtopics · Three Primary Types of Plans · Understanding Managed Care Plans · Understanding Preferred Provider Plans · Health Care Providers · Fee-for-Service Health Insurance Plans · Free Online Resources The Three Primary Types of Health Insurance Plans What are the different types of health insurance plans? Most health insurance companies offer a variety of health insurance plans, letting you select the best health insurance for your specfic needs. There are three main types of health insurance plans: Health Maintenance Organizations, HMOs, offer the most affordable health insurance option. However, they are also the most restrictive about working through primary health care providers who manage your care for the health insurance companies. Preferred Provider Organizations, PPOs, also encourage, but do not require, members to work through primary health care providers. If you see health care providers who are not on the health insurance plans' list, you will often pay higher health insurance costs. Fee-for-service health insurance plans are the least affordable health insurance coverage. However, they are also the most flexible, allowing members the most freedom to choose health care providers. Which type of plan is right for you can depend on many different factors. It is recommended to compare health insurance quotes from multiple sources in order to get a good idea of what is available to you before making a final decision. ^ Back to top Understanding Managed Care Health Insurance Plans What are managed care health insurance plans? Managed care is a more affordable health insurance option that offers individual health insurance, family health insurance, and group health insurance. Managed care health insurance companies contract with health care providers (hospitals and doctors) to care for members of their health insurance plans. Read your health insurance policy information carefully and check the health insurance plans' site to find health insurance coverage rules, and learn about all costs involved. Keep in mind that managed care health insurance plans generally provide affordable health insurance options if you use health care providers who are part of the plan. If you use health care providers outside of the plan, or network, costs can go up dramatically. ^ Back to top Understanding Preferred Provider Health Insurance Plans What are preferred provider health insurance plans? Preferred Provider Organizations (PPOs) generally give members the most flexibility about their choice of health care providers. A PPO gives members access to a network of health care providers who charge reduced rates. Members often have a choice of using the PPO or non-PPO provider, but there is a financial incentive to use the PPO health care provider. In other words, PPOs offer reduced health insurance costs for the health care providers within their network. To see out-of-network health care providers, members pay the difference between the health insurance companies' allowable cost and the health care providers' fee. ^ Back to top Understanding Health Insurance Terms - Definition of a Health Care Provider What are health care providers? The term "health care provider" (also sometimes referred to as "health care provider") is used to describe the hospitals, clinics, doctors, and other health care professionals who work for particular health insurance companies. Health insurance companies contract with a network of health care providers to provide the best health insurance coverage for members of their health insurance plans. Health insurance companies negotiate health insurance rates, allowing them to control health insurance costs and offer more affordable health insurance premiums to the members of their health insurance plans. Most health insurance companies offer an online health insurance database of their participating health care providers. ^ Back to top Understanding Fee-for-Service Health Insurance Plans What are fee-for-service health insurance plans? With fee-for-service health insurance coverage, also called point-of-service coverage, members select primary health care providers. The primary heath insurance providers then manage members' health care for the health insurance companies. Fee-for-service health insurance plans control health insurance costs by negotiating discounted health insurance rates with participating health care providers. Members of these health insurance plans only pay co-pays and deductibles if they see health care providers who are not participants of the health insurance companies' network. ^ Back to top Help Understading Health Insurance Terms - Free Online Resources Where can I go online to learn more about health insurance? Insurance Information Institute Medicare.gov - Official Site COBRA Insurance Information Source National Association of Insurance Commissioners More Helpful Health Insurance Resources ^ Back to top Note: This information is for general use only. Use this information as part of a full research process. General advice does not always apply directly to individual matters. Please consult a local expert with specific and complex questions about your individual situation. Recommend this page to a friend  ^ Back to top

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