What's the Most Popular Health Insurance Plan?

Although the most popular health insurance plan might not be the best for everyone, sometimes it helps to know what the most common health insurance other people choose for themselves and their families.

When it comes to the most popular health insurance plans, the majority of consumers still choose health maintenance organization (HMO) plans. According to an eHealth report, nearly half (49%) of shoppers selected an HMO health insurance plan in 2020. Although this number has dropped from 56% the previous year, it still topped the list followed by EPOs and PPOs. 

What’s remarkable about these numbers is how rapidly HMOs have expanded in popularity. As recently as 2014, PPOs were the most popular plan, accounting for 46 percent of individual plans purchased on eHealth. HMOs were only the second most popular health insurance plan, selected by 39 percent of shoppers. But in just three years, this plan has become a leading favorite among customers.

What is an HMO?

An HMO or health maintenance organization is a health insurance plan that is connected to a network of doctors, medical facilities, and other sources of care. HMOs are usually based in a specific geographical area, and limit covered care to that area. They set specific guidelines for who can join their network and what kind of care they can provide.

Are HMOs the most restrictive type of health care plan?

Although HMOs are some of the most popular health insurance plans, it doesn’t mean they offer the best coverage. The “best” coverage is different for everyone, depending on various factors like your specific health care needs and budget. If you are considering enrollment in an HMO plan, make sure you’re familiar with some of its trademark characteristics:

• Low Costs– For many enrollees, the greatest benefit of an HMO health insurance plan is its low cost. Because they negotiate directly with a specific network of physicians and facilities, HMOs often feature lower premiums, fewer co-pays, and reduced deductibles. In many cases, HMO plans do not include a deductible, which means you don’t need to spend a certain amount out-of-pocket before insurance begins contributing to your medical costs.
• Primary Care Considerations– In addition to their lower costs, HMOs have the benefit of requiring you to select a primary care physician and encouraging you to get your medical care from them. This means that your doctor will coordinate your care with other providers, which could lead to better care over the long haul.It also requires your primary doctor to provide referrals for you to see other providers or the services may not be eligible for coverage. 
• Network Restrictions– One criticism of HMOs is that they are not the most widely accepted health insurance option. . If you get care from a physician or facility that isn’t in the network, you’ll typically have to pay the entire cost out of pocket, except in certain circumstances such as when you need emergency care. This restriction is especially problematic if you have an illness or chronic disease that requires you to see specialists both in and out of your geographical area. If you foresee yourself needing access to very specific care that might not be included in an HMO’s network, then you might benefit more from a different type of plan.
• Network Size– Not only are HMOs usually more restrictive than other plans, but they tend to have smaller networks. This further limits your ability to get care, which might not be a problem for some, but might greatly affect people who have a specific need or doctor in mind.

What are PPO Health Plans? 

PPOs or preferred provider organizations are not the most popular health insurance plans, but they are a better fit for some individuals and families. Members of a PPO can see providers within a designated network, but if they choose a provider outside the network their insurance plan may still cover at least a portion of the visit. PPOs tend to feature larger networks and do not require patients to have a primary care physician to oversee their care or provide referrals to see other providers. However, the premiums, copayments, and deductibles are typically higher with a PPO. 

What is an EPO? 

An EPO or exclusive provider organization, is a health plan that falls somewhere between an HMO and a PPO. Members of these plans must see providers within the designated network to qualify for coverage. However, they are not required to get referrals from a primary care physician to see other providers. Cost for an EPO usually fall somewhere between an HMO and PPO. 

Which health care plan is the best for you? 

Ultimately, the best healthcare plan for you depends on your specific health needs and your financial situation. eHealth is committed to helping you obtain the plan that best fits these needs. We have licensed brokers in every state and thousands of plans to choose from, making it easy for you to find the best coverage for your specific needs and budget. For more information, visit our website today. They set specific guidelines for who can join their network and what kind of care they can provide.