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Plan basics

Plan types

We offer five types of individual plans:

  • Full network health maintenance organization (HMO)
  • HMO choice, which includes Henry Ford Choice and Genesys Choice
  • Preferred provider organization (PPO)
  • Catastrophic (individuals under 30)

Health insurance plan costs

When weighing health plan costs, we want you to be aware of costs that go beyond your premium. They include:

  • Copays
  • Coinsurance
  • Deductibles
  • Out-of-pocket limit

Let's break it down:

You can purchase one of these plans during open enrollment or during a special enrollment period or SEP.

Learn more about SEPs.

Health savings account

We offer health plans that can be paired with a health savings account (HSA). These plans have higher deductibles. An HSA is simply a bank account for health care expenses. Our HSAs come with a helpful debit card for easy access to your account. You can use your HSA card to pay for doctor visits, hospital stays, copays, eyeglasses, prescriptions and more.

Some benefits of using an HSA:

  • Contributions are made with pretax money
  • The interest you earn on your money isn't taxed
  • The money rolls over each year
  • The money goes with you, even if you change health plans or retire

Qualified health plans, essential health benefits and plan levels

Qualified health plans

Qualified health plans, known as QHPs, are Affordable Care Act-compliant plans that cover essential health benefits and follow established limits on out-of-pocket costs.

Essential health benefits

Essential health benefits, or EHBs are health care services that must be covered by all qualified health plans. EHBs include the following:

  • Ambulatory patient services
  • Emergency care
  • Hospitalization
  • Maternity and newborn care
  • Mental health and addiction services, as well as behavioral health care
  • Prescription drugs
  • Rehabilitative and habilitative care and devices like speech therapy or hearing aids
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including dental and vision care

Plan levels

Health plans are grouped into categories called metal tiers. They're designed to help you compare health plans with similar coverage. HAP offers silver, bronze and catastrophic tiers. Each tier shows how you and your plan share costs, The amount you pay for covered services, medications and medical supplies is called cost sharing. The different metal tiers are based on the percentage of health care costs the plan covers. Bronze plans usually have the lowest monthly premiums and highest out-of-pocket costs - copays, deductibles and coinsurance. Silver plans usually have higher monthly premiums and lower out-of-pocket costs.

Catastrophic plans offer coverage for higher-cost services such as hospitalization. This type of plan is available to individuals who are under 30 or who receive a hardship exemption from the government.

Ready to take the next step?

Need help? Call (855) 948-4427 to speak with a knowledgeable, certified representative.