Open Enrollment: Understand Your Healthcare Plans - PPO, HMO, HDHP

open-enrollment

PPO? HMO? HDHP? That Open Enrollment guide from HR might seem like alphabet soup, but Healthcare Hustlers don’t just blindly choose letters once a year. Our Hustlers know that choosing the appropriate healthcare plan can save or cost them thousands of dollars. We’ve outlined the most common options below.

Would you rather plug your plan information into a calculator to see which is best for you? Check out this open enrollment calculator.

Standard PPO Plan

Pros:
Low deductibles
Predictable office visit & prescription copays

Cons:
Highest premiums

Best For:
Medium healthcare utilizers, especially those who get frequent lab tests or office visits
Low risk takers

Slightly Cheaper PPO Plan

Pros:
Medium deductible
Predictable office visit & prescription copays

Cons:
High premiums

Best For:

Low to Medium healthcare utilizers, especially those who get frequent lab tests or office visits

Low risk takers

HMO Plan

Pros:
Medium premiums
Medium deductible
Predictable office visit & prescription copays

Cons:
Smaller networks (limited choice of providers)

Best For:
Hustlers who rarely leave their geographic area
Medium healthcare utilizers who are more cost conscious

Tip: Make sure your provider is in-network before you sign up for this plan. You can check on the insurance website.

High Deductible Health Plan (HDHP)

Pros:
Low premiums
Usually paired with a tax free Health Savings Account (HSA)

Cons:
High deductible
High cost sharing on all services
Unpredictable costs for office visits and prescription copays

Best for:
Extremely LOW healthcare utilizers - you only use preventive care, 100% covered prescriptions (such as birth control) plus the occasional doctor visit

Extremely HIGH healthcare utilizers - you are likely to meet your out of pocket maximum, at which point you will no longer be responsible for costs as long as you stay in-network

Hustlers with enough savings (in regular account or HSA) to cover their deductible in case of emergency.

Tips:

Have you already enrolled in a plan and need to find a provider? Check this out!