{"id":24451,"date":"2026-04-25T21:46:33","date_gmt":"2026-04-25T21:46:33","guid":{"rendered":"https:\/\/incredipros.com\/?p=24451"},"modified":"2026-04-25T21:46:34","modified_gmt":"2026-04-25T21:46:34","slug":"how-to-compare-health-insurance-plans","status":"publish","type":"post","link":"https:\/\/incredipros.com\/?p=24451","title":{"rendered":"How to Compare Health Insurance Plans"},"content":{"rendered":"<p>Do you know what the most wonderful time of the year is? Nope\u2014not Christmas. We\u2019re talking about open enrollment season. It\u2019s the one time of the year you get to review and compare health insurance plans to find the right one for you.<\/p>\n<p>Okay, you got us. No one\u2019s throwing parties over picking a health plan. But when it\u2019s time to choose, it matters. The plan you pick affects your coverage, monthly premium, out-of-pocket costs and even which doctors you can see.<\/p>\n<p>And we get it\u2014health insurance terms can feel like a foreign language. But don\u2019t worry. We\u2019ll break down the basics so you can understand your options and actually feel confident about your decision and protection.<\/p>\n<div id=\"compare-health-insurance-plan-networks\">\n<p><h2>Compare Health Insurance Plan Networks<\/h2>\n<\/p>\n<p>We get it. Health insurance is full of weird jargon and acronyms. It\u2019s like trying to do sudoku on the subway\u2014confusing and just a little scary. Well, consider this your health insurance cheat sheet and map all in one, because we\u2019re going to walk you through the different types of health insurance plans and how they actually work\u2014minus the confusing stuff.<\/p>\n<p>First, if you have a job with an employer who provides health insurance, talk to your workplace health insurance administrator. They should be able to explain how to choose between the health insurance options you have at work.<\/p>\n<p>If your company\u00a0<em>doesn\u2019t<\/em>\u00a0offer a health plan or if you\u2019re self-employed, we\u2019re here to explain how to compare health insurance plans. Let\u2019s go over the main types of available health plan networks.<\/p>\n<h3>Preferred Provider Organization (PPO)<\/h3>\n<p>Preferred Provider Organization\u2014the words get longer as the name unfolds! Let\u2019s just say <em>PPO<\/em>. These are health plans that contract with hospitals and doctors to create a network of (you guessed it) preferred providers.<\/p>\n<p>PPOs also have coverage for doctors\u00a0<em>outside<\/em>\u00a0of their networks, but there\u2019s a catch for the flexibility. You\u2019ll pay more out of pocket\u2014often\u00a0<em>a lot<\/em>\u00a0more\u2014than if you see the plan\u2019s\u00a0<em>preferred\u00a0<\/em>providers. Emergency care is usually the exception to the rule.<\/p>\n<p>These plans are the most popular for people who get their health insurance through work, with 48% of covered workers enrolled in a PPO.<sup>1<\/sup><\/p>\n<h4><strong>PPO Pros and Cons<\/strong><\/h4>\n<p><strong>Pro:<\/strong> Most PPOs have a decent selection of providers to choose from in your area. Just be sure you know which providers accept your plan before getting any treatment so there are no surprises.<\/p>\n<p><strong>Con:<\/strong> Higher premiums make PPOs more expensive than other types of plans, like HMOs.<\/p>\n<h3>Health Maintenance Organization (HMO)<\/h3>\n<p>A Health Maintenance Organization (HMO) is a health insurance plan that usually only covers care from doctors who work for (or contract with) that specific plan.\u00a0So unless there\u2019s an emergency, your plan will\u00a0<em>not<\/em>\u00a0pay for out-of-network care. Another restriction: HMOs often work only in a specific geographic area. Your health care coverage will be defined by either where you live or where you work.<\/p>\n<h4><strong>HMO Pros and Cons<\/strong><\/h4>\n<p><strong>Pro:<\/strong> Lower out-of-pocket expenses make HMOs attractive.<\/p>\n<p><strong>Con:<\/strong> There\u2019s not much flexibility. When it comes to choosing providers, it\u2019s like what your teacher told you in preschool: You get what you get, and you don\u2019t throw a fit.<\/p>\n<h3>Exclusive Provider Organization (EPO)<\/h3>\n<p>Ready for another acronym? An Exclusive Provider Organization (EPO) is another type of managed care plan (like an HMO) where services are only covered if you use doctors, specialists and hospitals in the plan\u2019s network (except in emergencies).<\/p>\n<p><em>Unlike<\/em>\u00a0HMOs however, EPOs do not require a primary care physician (PCP) referral to see a specialist. Sound appealing? This might be the right network plan for you if you want the freedom to see specialists without a referral\u00a0<em>and<\/em>\u00a0you don\u2019t mind being limited to health care providers in your network.<\/p>\n<h4><strong>EPO Pros and Cons<\/strong><\/h4>\n<p><strong>Pros:<\/strong> Premiums are usually lower. Plus, there\u2019s no need for a PCP referral to see a specialist.<\/p>\n<p><strong>Cons:<\/strong> You\u2019re limited by a smaller network of health care providers. Most services require preauthorization from the insurance company.<\/p>\n<h3>Point of Service (POS)<\/h3>\n<p>A Point of Service (POS) plan combines the features of HMOs and PPOs by providing different benefits based on whether you use in-network or out-of-network providers. POSs do provide\u00a0<em>some<\/em>\u00a0coverage for seeing an out-of-network provider, and your PCP will coordinate the care.<\/p>\n<h4><strong>POS Pros and Cons<\/strong><\/h4>\n<p><strong>Pros:<\/strong> You\u2019ll find more provider options to choose from. Your PCP will coordinate your specialist care.<\/p>\n<p><strong>Con:<\/strong> Referrals are required.<\/p>\n<p>Cross-eyed yet? To clear things up, we summarized all the features we just discussed in the handy table below.<\/p>\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Network Plan Type<\/strong><\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\"><strong>Do you have to stay in network to get coverage?<\/strong><\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\"><strong>Do procedures and specialists require a referral?<\/strong><\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\"><strong>Summary Snapshot<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">PPO: Preferred Provider Organization<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">No, but in-network care is less expensive<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">No<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">More provider options and no required referrals, but higher out-of-pocket costs<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">HMO: Health Maintenance Organization<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">Yes, except for emergencies<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">Yes, typically<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">Lower out-of-pocket costs and a primary doctor who coordinates your care for you, but less freedom to choose providers<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">EPO: Exclusive Provider Organization<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">Yes, except for emergencies<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">No<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">Lower premiums and no required referrals, but less freedom to choose providers<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">POS: Point of Service<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">No, but in-network care is less expensive<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">Yes<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">More provider options and a primary doctor who coordinates your care for you, with referrals required<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<div class=\"self-employed-health-insurance-options\">\n<h2>\u00a0<\/h2>\n<p><h2>Self-Employed Health Insurance Options<\/h2>\n<\/p>\n<\/div>\n<p>Let\u2019s be real\u2014health insurance isn\u2019t optional. Yes, that includes you self-employed folks too. Self-employed health insurance just means you\u2019re buying an individual plan for yourself and your family instead of getting group coverage through an employer. Here are a few options to get you started:<\/p>\n<ul>\n<li><strong>Federal and state health insurance marketplaces:<\/strong> A great place to start shopping for self-employed health insurance is the federal marketplace at healthcare.gov. Here, you can compare and enroll in private health insurance plans\u2014unless you live in a state with its own marketplace (like California, Massachusetts or Colorado). In that case, you\u2019ll use your state\u2019s site instead.<\/li>\n<li><strong>Medicaid and Medicare:<\/strong> Medicaid is a federal program that provides free insurance for low-income folks. Medicare, on the other hand, offers government-sponsored health care for people over 65. If you\u2019re 65 or over and don\u2019t have health insurance through an employer (or you\u2019re retired), this is a solid option.<\/li>\n<li><strong>TRICARE:<\/strong> Are you self-employed military vet? TRICARE provides coverage for active-duty service members, military retirees and their families, and survivors. Vets can also apply for VA coverage.<\/li>\n<li><strong>Membership organizations:<\/strong> If you\u2019re part of a freelancer\u2019s union or membership group, you may have access to discounted, industry-specific health insurance. Just be sure to compare the details here\u2014some of these plans can cost more and cover less than you\u2019d find on the marketplace. A solid one to check out is the National Association for the Self-Employed.<\/li>\n<li><strong>Direct enrollment or private exchanges<\/strong>: Some insurance companies will let you purchase a plan directly\u2014skipping the federal or state marketplace. Just be cautious here. These plans often offer fewer options, and you could end up feeling pushed into a plan that\u2019s not the best fit.<\/li>\n<\/ul>\n<p>These are just a handful of health insurance options for self-employed folks. If you feel like you need an extra hand here, be sure to get in touch with an independent insurance pro. They\u2019ll help you navigate the marketplace and pick the best health coverage for you.<\/p>\n<div class=\"health-insurance-without-a-job\">\n<p><h2>Health Insurance Without a Job<\/h2>\n<\/p>\n<\/div>\n<p>Lost your job? Yeah, it stinks. And adding health insurance stress on top of it doesn\u2019t help. But take a breath\u2014you still have options for health coverage (many of which overlap with self-employed health insurance, so you\u2019re in good company here). The key is to act quickly, understand your eligibility, and compare costs so you don\u2019t end up uninsured.<\/p>\n<p>Here are eight solid ways to get health insurance without a job:<\/p>\n<ul>\n<li><strong>Short-term health insurance:<\/strong> temporary coverage between jobs<\/li>\n<li><strong>COBRA:<\/strong> allows you to keep your employer plan temporarily (but at full cost)<\/li>\n<li><strong>Marketplace plans:<\/strong> government-run plans with possible subsidies (financial assistance)<\/li>\n<li><strong>Medicaid or CHIP:<\/strong> income-based coverage for individuals and families<\/li>\n<li><strong>Medicare: <\/strong>for those 65 and over or with qualifying disabilities<\/li>\n<li><strong>Private individual plans:<\/strong> bought directly from an insurer or agent<\/li>\n<li><strong>Health cost sharing:<\/strong> nontraditional coverage through community sharing (more on this in a minute)<\/li>\n<li><strong>Spouse\u2019s or parent\u2019s plan:<\/strong> joining a family member\u2019s coverage if eligible (this could be the easiest route to take if it\u2019s available)<\/li>\n<\/ul>\n<p>Like we said, time is key\u2014but there\u2019s no need to panic. Start as soon as you can, gather all the important details and paperwork, get guidance from an independent insurance agent, and lean on your emergency fund if you need to (that\u2019s exactly what it\u2019s there for!).<\/p>\n<div class=\"special-needs-health-coverage\">\n<p><h2>Special Needs Health Coverage<\/h2>\n<\/p>\n<\/div>\n<p>Next, let\u2019s talk about health coverage for those with special needs. Basically,<strong> Special Needs Plans (SNPs)<\/strong> are designed for individuals with chronic or disabling conditions. They often offer more specialized health coverage through Medicare (and sometimes Medicaid). <strong>Dual Eligible Special Needs Plans (D-SNPs)<\/strong> combine both Medicare and Medicaid programs for those who qualify, providing broader support for medical costs.<\/p>\n<p>If you or a loved one falls into either of these categories, taking the time to understand how these options work can bring you a lot of peace now and down the line.<\/p>\n<p><h2>Compare Health Insurance Plan Metal Categories<\/h2>\n<\/p>\n<p>When you\u2019re shopping for a plan on healthcare.gov or your state exchange, the plans are shown in four \u201cmetal\u201d categories (no, not like M\u00f6tley Cr\u00fce). The plans are tiered according to\u00a0how much they cost\u00a0and what they cover: Bronze, Silver, Gold and Platinum.<\/p>\n<p>Key fact: If you\u2019re eligible for \u201ccost sharing reductions\u201d under the Affordable Care Act, you<em>\u00a0must\u00a0<\/em>pick a Silver plan or better to get those reductions.<sup>2<\/sup><\/p>\n<p>Plans in every category provide some types of free preventive care, and some offer free or discounted health care services before you meet your deductible. The way it basically works is this: Bronze plans have the<em>\u00a0lowest<\/em>\u00a0monthly premiums but the\u00a0<em>highest<\/em>\u00a0out-of-pocket costs. As you work your way up through the Silver, Gold and Platinum categories, you pay more in premiums, but less in deductibles and coinsurance.<\/p>\n<p>But as we mentioned before, the extra costs in the Silver category can be minimized<em>\u00a0if\u00a0<\/em>you qualify for the cost sharing reductions. So you\u2019ll want to make sure you\u2019re getting the maximum value of those reductions when you\u2019re shopping for health plans. Reductions can lower your out-of-pocket health care costs a lot, so get with a health insurance pro through our friends at\u00a0Health Trust Financial,\u00a0who can help you find out what you may be eligible for.<\/p>\n<p>The table below shows the percentage that the insurance company pays\u2014and what you pay\u2014for covered expenses after you meet your deductible in each plan category.<\/p>\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Plan Category<\/strong><\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\"><strong>How Much the Insurance Company Pays After Deductible<\/strong><\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\"><strong>How Much You Pay<\/strong><\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\"><strong>Premium<\/strong><\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\"><strong>Deductible<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Bronze<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">60%<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">40%<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">Lowest<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">Can be thousands of dollars annually<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Silver<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">70%<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">30%<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">Low<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">Lower than bronze<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Gold<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">80%<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">20%<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">High<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">Low<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p style=\"text-align: center;\">Platinum<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">90%<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">10%<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">Highest<\/p>\n<\/td>\n<td>\n<p style=\"text-align: center;\">Very low<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>\u00a0<\/h2>\n<p><h2>Compare Health Insurance Plan Total Costs<\/h2>\n<\/p>\n<p>When you choose your health insurance plan, here\u2019s something to pay close attention to: extra costs beyond your monthly premium.<\/p>\n<p>Other costs, often called \u201cout-of-pocket\u201d costs, can add up quickly. Things like your deductible, your copay, your coinsurance amount and your out-of-pocket maximum can have a big impact on the total cost. Here are some expenses to keep close tabs on:<\/p>\n<ul>\n<li><strong>Deductible<\/strong><strong>:<\/strong> the amount you pay before your insurance company pays anything (except for free preventative care)<\/li>\n<li><strong>Copay<\/strong><strong>:<\/strong> a set amount you pay each time for things like doctor visits or other services<\/li>\n<li><strong>Coinsurance<\/strong><strong>:<\/strong> the percentage of health care costs you\u2019re responsible for paying after you\u2019ve hit your deductible for the year<\/li>\n<li><strong>Out-of-pocket maximum<\/strong><strong>:<\/strong> the annual limit on what you\u2019re responsible for paying on your own<\/li>\n<\/ul>\n<p><h2>Learn How to Save Money on Health Insurance<\/h2>\n<\/p>\n<p>One of the best ways to save money on health insurance is to use a\u00a0high-deductible health plan (HDHP), especially if you don\u2019t expect to regularly use medical services. Just like the name says, these are health plans with high deductibles.\u00a0You\u2019ll pay a lot more out of pocket for health care costs before your plan kicks in, but these plans also have lower monthly premiums.<\/p>\n<p>You can apply this high deductible\/low premium strategy to any of the health insurance network plans we discussed earlier (HMOs, PPOs, EPOs or POSs).<\/p>\n<p>Here\u2019s the thing that makes HDHPs truly awesome\u2014they can be combined with a\u00a0Health Savings Account (HSA). That\u2019s an account that lets you set aside money tax-free to pay for qualified medical expenses.<\/p>\n<p>You may be asking yourself,\u00a0<em>Wait a minute\u2014who determines what they mean by \u201chigh\u201d deductible?<\/em><\/p>\n<p>That\u2019s a great question. The IRS does. And for 2025, the IRS defines a high-deductible health plan as any plan with a deductible of at least $1,650 for an individual or $3,300 for a family. An HDHP\u2019s total yearly out-of-pocket expenses (including deductibles, copayments and coinsurance) can\u2019t be more than $8,300 for an individual or $16,600 for a family.<sup>3<\/sup>\u00a0(This limit doesn&#8217;t apply to out-of-network services.)<\/p>\n<p>And the HSA is a great feature of HDHPs because you can contribute up to $4,300 for an individual and $8,550 for a family\u00a0<em>tax-free\u00a0<\/em>for 2025.<sup>4<\/sup><\/p>\n<p>Even better, this money rolls over if you don\u2019t use it, and you can even invest the money in your HSA so that it grows tax-free.<em>\u00a0<\/em>That\u2019s awesome! Being able to\u00a0open an HSA\u00a0is great for your future.<\/p>\n<p>Another way to save money on health insurance? Skipping cancer insurance. Now, that sounds scary. But here\u2019s the deal\u2014you don\u2019t pay extra for heart attack insurance, right? That\u2019s because a solid health insurance plan covers heart attacks. Same principle applies here. What you do need is a good health insurance plan that covers cancer treatments (most do), long-term disability insurance, and a fully funded emergency fund. That\u2019s it!<\/p>\n<\/div>\n<p>Read the full article <a href=\"https:\/\/www.ramseysolutions.com\/insurance\/compare-insurance-plans\" target=\"_blank\" rel=\"noopener\" rel=\"nofollow\">here<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Do you know what the most wonderful time of the year is? Nope\u2014not Christmas. We\u2019re talking about open enrollment season. It\u2019s the one time of the year you get to review and compare health insurance plans to find the right one for you. Okay, you got us. No one\u2019s throwing parties over picking a health<\/p>\n","protected":false},"author":1,"featured_media":24452,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[55],"tags":[],"class_list":{"0":"post-24451","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-news"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>How to Compare Health Insurance Plans | IncrediPros<\/title>\n<meta name=\"description\" content=\"Do you know what the most wonderful time of the year is? Nope\u2014not Christmas. We\u2019re talking about open enrollment season. 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