Insurance Plans for Families

Employers often offer commercial health care insurance for their employees, typically giving you a choice of multiple types of plans with different benefit and cost structures. Employer-based plans typically offer coverage for major medical expenses, such as doctor and hospital costs, and often include prescription drug benefits. If your employer does not offer insurance, or you are unemployed, you may qualify for coverage offered through government programs.

Health Maintenance Organizations

• Health Maintenance Organizations (HMOs) have a network of hospitals, doctors and specialists that participate in the plan. You must choose a primary doctor from within the network, who serves as the coordinator for all of your health care needs. If the primary physician cannot provide the services you need, she can refer you to another health care providers. When you use providers within the network, the plan pays for services according to the terms of the plan. If you choose to use providers that do not participate in the network, you can face much higher costs. HMOs often require participants to pay copayments or coinsurance for services.

Preferred Provider Organizations

• Preferred Provider Organizations (PPOs) have a network of physicians, health care specialists and hospitals that agree to provide services at discounted rates, which they negotiate with the insurance provider. PPOs do not require you to choose a primary doctor. As long as you receive all of your health care services from within the network, your receive costs according to the terms of the plan. Services receive from providers outside the network can increase the cost of your copayments or deductible.

Health Savings Accounts

• Health Savings Accounts (HSAs) offer a newer type of health care plan. An HSA works like a saving account, which you can use to pay for your health care services. You typically pay a lower premium with an HSA, compared to PPOs or HMOs, but often pay a higher deductible. The plan deposits money into a tax-free account, which can grow to cover your future health care needs. The money deposited in the HSA account remains yours, and you can choose how to invest your funds. HSAs do not require you to receive services from within a network of providers, allowing you to choose your doctor, hospital and health care specialists.

Government Plans

• The federal government offers Medicare coverage for individuals 65 years of age and older and people with disabilities. Medicare provides major medical coverage to pay your doctor and hospital expenses. Medicare coverage includes three parts, which you enroll in separately: Part A covers hospital care; Part B covers physician costs; and Part D pays for prescription drugs. Medicare also offers Medicare Advantaged plans, which private insurance companies administer. Advantage plans typically cover hospital care, doctor fees and have a prescription drug benefit.

  Medicaid provides coverage for low-income individuals and families. Each state administers its own Medicaid program. Eligibility for Medicaid, and the benefits you receive, can depend on where you live.