Health Insurance Guide

Understand the major types of health plans available.

The most common types of medical insurance plans are:

PPO: Preferred Provider Organization

PPOs offer the most freedom. They have arrangements with medical providers who have agreed to accept lower fees. As a result, you pay less for in-network providers, but you may also use providers outside the network. No referrals or primary care practitioners (PCPs) are required. Our PSN (PacificSource Network) in Oregon is an example of a PPO network. Browse plans >>  

Coordinated Care Network

Coordinated Care Networks are networks of providers where you first select a primary care provider, called a PCP, as your “main” doctor. Your PCP will then coordinate other care as needed, such as referring you to specialists. You get the highest level of benefits by seeing providers that are part of the network. Our SmartAlliance and BrightIdea networks in Idaho are examples of Coordinated Care Networks. Browse plans >>  

Tiered Network Plans

Tiered Networks feature three tiers of providers to give you more choice. You'll choose a primary care provider (PCP) from tier 1 who will partner with you to meet your health and wellness goals. Our SmartHealth network in Montana and Boise is an examle of a Tiered Network. Browse plans >>  

CDHP: Consumer-Directed Health Plans

CDHPs are a type of health plan designed to:

  • Help hold down healthcare premiums
  • Give consumers more control over how their healthcare dollars are spent
  • Feature a low-cost, high-deductible PPO plan plus a healthcare spending account

You use the spending account funds to pay for services while meeting your health plan deductible or for health-related services not covered by your plan, such as dental or alternative care. There’s normally a financial incentive for you to spend your account dollars wisely, such as allowing your account balance to carry over from year to year. Learn more about these plans in Consumer-Directed Health Plans 101.

HMO: Health Maintenance Organization

HMOs are the most restrictive type of managed care. You choose a primary care doctor, and specialist services are covered only if referred by your primary care doctor. HMOs usually only cover services provided by doctors in their network; if you go outside the HMO for care, you will probably pay the bill. We do not offer HMO plans.  

POS: Point-of-Service Plan

POS plans are a cross between an HMO and a PPO, allowing more flexibility with providers than an HMO. With a POS plan, primary care doctors usually refer patients to other providers in the network. You can also self-refer to providers outside the plan and receive limited coverage. We do not offer POS plans.  

Learn more: Decide which plans and companies might meet your needs. >