Individual and Family
What's the Most Popular Health Insurance Plan?
Published on July 24, 2018
Although the most popular health insurance plan might not be the best for everyone, sometimes it helps to know what is favorable among the masses.
When it comes to individual health insurance, the majority of consumers choose health maintenance organization (HMO) plans. With 53 percent of customers shopping for major medical insurance choosing HMO plans, you could say that these are the most “popular” plans in terms of how many eHealth customers are choosing them. Keep reading to learn more about how this plan works, and whether or not it could be the one for you.
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.
HMOs have recently emerged as the most popular type of health insurance plan among eHealth shoppers. According to a recent study, 53 percent of such shoppers selected an HMO health insurance plan in 2017; the second most popular health insurance plan, the preferred provider organization or PPO, was selected by 22 percent of shoppers.
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.
Do HMOs offer the best coverage?
Although HMOs are the most popular choice for eHealth shoppers, it doesn’t mean they offer the best coverage. Really, the “best” coverage is different for everyone, depending on various factors like health care needs and financial situation. It’s important to determine which health insurance plan provides the best coverage for your specific needs. If you’re considering enrolling in an HMO-style 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 are often able to demand lower premiums, fewer co-pays, and reduced deductibles. In many cases, you will not have to reach a deductible for your HMO, which means you don’t need to spend a certain amount out-of-pocket before insurance begins contributing to your medical bills.
- 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 have a chance to review your entire health history, get to know your specific needs and goals, and develop care tailored to those factors. This could lead to better care over the long haul, due to an established patient-doctor relationship.
- Network Restrictions– One criticism some people may have for HMOs, is the restrictive nature of this plan type. 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 serious 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 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 doctor in mind.
Each plan has its own terms and limitations, so be sure to check the official plan documents to understand how that specific plan works. This article is only for general education. To learn more about other plan options, read more here.
Ultimately, whether HMOs provide the best coverage depends on your specific health needs and your financial situation. eHealth is committed to helping you obtain the plan that best fits these needs. For more information, visit our website today.