While it’s great to have a wide range of health plan options available to you, each balances costs and coverage differently, so it’s important to know the differences between them.
We’re here to help with information about some of Michigan’s most common health plan types, which are HMO, HDHP and narrow network plans.
What is an HMO?
An HMO or “health maintenance organization” plan is the most common type in Michigan. An HMO offers affordable, reliable care by having you see in-network providers only.
How it works: You’ll need to choose a primary care provider (PCP) to oversee your care. You’ll be able to use doctors and hospitals that are part of a large network and with a Priority Health plan, you can often even see in-network specialists without a referral. But keep in mind that you won’t be covered for out-of-network services unless it’s a medical emergency.
Insider tip: Make sure you’re enrolled in a plan with a large HMO network. This gives you access to a wider range of doctors and hospitals.
What is a high-deductible health plan (HDHP)?
An HDHP, or high-deductible health plan, is a popular choice for people who are generally healthy and want to keep monthly costs on the low side. It offers lower premiums in exchange for a higher deductible, meaning you’ll pay more out-of-pocket before your plan starts covering most medical expenses.
How it works: You’ll pay a higher deductible upfront before your insurance kicks in. After that, you’ll typically only pay copays and coinsurance. HDHPs often pair with a Health Savings Account (HSA), which lets you save pre-tax dollars to pay for qualified medical expenses—even those not covered by your plan.
Insider tip: If you’re considering an HDHP, check if it includes chronic condition coverage or preventive drug benefits. And take advantage of an HSA—it’s a smart way to save for health costs and even future retirement needs.
What is a narrow network?
A narrow network consists of a group of doctors, hospitals, labs and outpatient facilities focused on providing care at a lower cost. They provide all the regular benefits of traditional coverage while you receive care within a set health system network.
If you’re happy with the hospitals and physicians included in the narrow network (or you already see a doctor in the network you’re considering) and want to keep your premium costs down, this might be the option for you. Technology makes a Narrow Network plan more open as well. And, like all other Priority Health Individual health plans, Priority Health Narrow Network plans offer virtual care options, like virtual urgent care, allowing you to manage your health from the comfort of your home or office through your computer or mobile device.
How it works: Agreements between a health insurance company and providers keep costs down within a narrow network. That means lower costs for services, but only with those specific providers. If a doctor, lab or hospital isn’t in the network, you’ll have to pay 100% of the cost — except in the case of a medical emergency.
Insider tip: Understand exactly where you can (and cannot) go for care. Some narrow networks use major, regional health care systems, so you may have more options than you realize.
If you’d like to learn more about health plans and how to save on coverage costs, visit the Individual and family health plan Learning Center. Regardless of which plan type is right for you, Priority Health has one that will meet your needs, so you can get care when and where you need it.
