MedAdvisor helps US consumers understand health plans, estimate potential out-of-pocket costs, compare savings strategies, and navigate healthcare coverage decisions — with clear, independent information built around how coverage actually works.
Before comparing plans line by line, these four figures tell you most of what you need to know about cost and structure.
The plan structure — HMO, PPO, EPO, or Marketplace — sets network rules and referral requirements.
The fixed amount paid each month to keep coverage active, regardless of how much care is used.
What's paid out of pocket for covered care before the plan starts sharing most costs.
The ceiling on covered costs in a plan year — once reached, the plan pays 100% of covered care.
Each plan type balances flexibility, referral requirements, and cost differently. Here's how they compare at a glance.
| Plan Type | Network Flexibility | Referral Requirements | Cost Structure | Best Fit |
|---|---|---|---|---|
| HMO | Lower — in-network only | Usually required | Lower premiums | Predictable, routine care |
| PPO | Higher — in and out of network | Not required | Higher premiums | Specialist flexibility |
| EPO | Moderate — in-network only | Typically not required | Mid-range premiums | Balance of cost and choice |
| Marketplace | Varies by metal tier | Varies by plan | Income-based subsidies possible | Individuals without employer coverage |
Enter a few plan details to see an estimated annual cost picture — premium, out-of-pocket exposure, and total.
Illustrative estimate only. Actual costs vary by plan design, provider network, and covered services.
Both accounts help set aside pre-tax money for healthcare costs, but eligibility, portability, and rollover rules differ in ways that matter over time.
Eligibility — HSAs require enrollment in a qualifying high-deductible health plan; FSAs are offered through many employer plans.
Rollover — HSA balances roll over fully each year; FSA rollover is limited and set by the employer's plan.
Portability — HSAs belong to the individual and move with them between jobs; FSAs generally stay with the employer.
Coverage decisions go smoother when approached in order — from understanding the basics to weighing savings tools last.
Learn how the plan type structures networks, referrals, and cost sharing.
Consider expected visits, prescriptions, and procedures for the year ahead.
Weigh premiums against deductibles and the out-of-pocket maximum.
Confirm preferred providers and facilities participate in the plan's network.
Decide whether an HSA or FSA fits your eligibility and spending pattern.
Federal privacy rules and consumer protections shape how healthcare information is handled and how plans must treat enrollees. A basic understanding helps you ask better questions.
Learn about HIPAA protocolsUse the plan analyzers to estimate real cost scenarios, or start with the coverage guides to understand how your options actually work.