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Medicare is a social insurance program that provides health insurance coverage to people who are 65 and over, or who meet special criteria. Medicaid, on the other hand, refers to a jointly funded state and federal insurance program administered by the states to provide healthcare for certain low-income individuals and families in order to reimburse hospitals and physicians for providing care to qualifying people who cannot finance their own medical expenses.

Dental coverage is becoming increasingly rare and is often limited to basic preventative care (i.e. cleanings and x-rays). For this reason, the coverage is generally priced at the actual cost of the benefit plus an administrative charge and is not considered very cost effective. Vision coverage applies to glasses and other basic eye care. Benefits are generally limited to an annual stipend for glasses and/or contact lenses as well as an associated annual checkup.

A Healthcare Management Organization or HMO is a type of Managed Care Organization (MCO) that provides a form of health insurance coverage fulfilled through hospitals, doctors, and other providers with which the HMO has a contract.

More often than not, behavioral or mental health coverage falls under its own heading. Insurers typically cap behavioral health benefits at a few thousand dollars when offered. For that reason, along with the stigma associated with behavioral health, many facilities are self-pay and many people opt to pay out of their own pocket to avoid the risk that their employer or co-workers will be made aware of their condition.

PPO stands for Preferred Provider Organization. A PPO is a managed care organization of medical doctors, hospitals, and other health care providers who have contracted with an insurer or a third-party administrator to provide health care at reduced rates to insurer’s or administrator’s clients.

A POS plan, or Point-of-Service plan, is a lesser known health insurance plan for which you must select a PCP who will direct your referral within the POS network. You will have little to no deductible and pay a small co-pay up front. Like a PPO, if you choose to see a provider who is out-of-network, you are likely to be subject to a deductible and your co-pay will become 30-40% of the provider’s total charges.

TRICARE is the US military managed healthcare program for the military, dependents, and retirees and replaced the previous CHAMPUS plan. The program is managed by TRICARE Management Activity (TMA) and contracts with several large health insurance corporations to provide claims processing, customer service and other administrative functions.