An HMO (Health Maintenance Organization) plan gives you personal care from a set network of doctors and hospitals. Out-of-Network care is still covered in urgent or emergency situations or with an approved prior authorization. Members choose a primary care provider (PCP) to coordinate care. The PCP can also refer members to a specialist, if the specialist requires a referral.
A PPO (Preferred Provider Organization) plan gives you the freedom to go out of network, but you'll pay more than if visiting a doctor in your plan's network. You're also not required to choose a primary care provider (PCP). Health Alliance doesn't require members to get a referral for specialty care, although some practices may require it.
A POS (Point of service) plan gives you personal care and freedom to go out of network, but with greater out-of-pocket costs. And they give you the comfort of having an in-network PCP to oversee all your care and refer you to see specialists, much like an HMO.
Some plans qualify to be paired with an HSA (noted with "HSA" in the plan name). Health Savings Accounts help individuals, employers and employees save money tax-free for medical expenses.
The Individual Coverage Health Reimbursement Arrangement (HRA) is an alternative to offering a traditional group health plan to your employees. It’s a specific account-based health plan that allows employers to provide defined non-taxed reimbursements to employees for qualified medical expenses, including monthly premiums and out-of-pocket costs, like copayments and deductibles. Employees must be enrolled in individual health insurance coverage (like a plan they bought through the Marketplace) to use the funds.
Catastrophic plans are only available through the Health Insurance Marketplace to people under 30 years old who don’t have access to affordable coverage. They give you low-cost protection, but they have high out-of-pocket costs.
Illinois currently participates in the Federally Facilitated Health Insurance Marketplace. Think of this marketplace as an online mall where you shop to find the perfect item, or in this case, the perfect health insurance plan. Depending on your income and family size, you may qualify for a subsidy. A subsidy is a premium tax credit that helps lower your monthly premium total. Visit HealthAlliance.org/Individual and use our subsidy tool to see if your household is eligible. You can also purchase Individual and Family plans directly from us.