How Do I Choose a Plan?

Plan Types

What is an HMO?

An HMO (Health Maintenance Organization) plan gives you personal care from a set network of doctors and hospitals. Out-of-Network care is still covered in urgent or emergency situations or when a physician submits a referral or authorization. Members choose a primary care provider (PCP) to coordinate care. The PCP can also refer members to a specialist, if the specialist requires a referral.

What is a PPO?

A PPO (Preferred Provider Organization) plan gives you the freedom to go out-of-network, but you'll pay more than if visiting a doctor in your plan's network. You're also not required to choose a primary care provider (PCP). Health Alliance doesn't require members to get a referral for specialty care, although some practices may require it.

What is a POS?

A POS (Point of Service) plan gives you personal care and the freedom to go out-of-network, but you will still pay more. And they give you the comfort of having an in-network PCP to oversee all your care and refer you to see specialists, much like an HMO.

What is a Short-Term Plan?

Short-term plans help with medical costs if you change jobs, missed enrollment or are waiting to begin other coverage. You choose your coverage length from one to six months, and can start as early as the next day (after applying). Short-term plans are not recognized by the government as meeting minimum essential health coverage.

What is a Health Savings Account (HSA)?

Some plans qualify to be paired with an HSA (noted with "HSA" in the plan name). Health Savings Accounts help individuals, employers and employees save money tax-free for medical expenses.

What is a High Deductible Health Plan (HDHP)?

HDHP are plans where you pay higher out-of-pocket costs in exchange for a lower monthly premium.

What is a Catastrophic Plan?

Catastrophic plans are only available to people under 30 years old who don’t have access to affordable coverage. They give you low-cost protection, but they have high out-of-pocket costs.


How Do I Find a Plan on the Public Marketplace?

The Affordable Care Act had each state make a Public Marketplace. Think of this marketplace as an online mall where you shop to find the perfect item, or in this case, the perfect health insurance plan. You might qualify for help paying for these plans.

Or you can buy individual and family plans directly from us.

Shopping By Cost

Plans in the Public Marketplace are put into metal levels based on the percentage of care costs the plan pays.

Bronze
60% of costs covered

Silver
70% of costs covered

Gold
80% of costs covered

  • Lower premiums mean higher out-of-pocket costs. Higher premiums mean lower out-of-pocket costs.
  • If you know you’ll need a lot of medical care or a surgery, a gold plan will cover more of those expenses.
  • If you think you won’t use your plan outside checkups, a bronze or silver plan will have lower premiums, and you'll be covered in an emergency.

What Should I Keep in Mind While Shopping?

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