Options in Medicare and Medicaid (both government based insurance) are limited by the state and area of the country in which you live. You may choose from a fee-for-service or managed care Medicare plan but may want to check with your local social security office or state office on aging for details. In some states, Medicaid recipients must choose a managed care plan but, again, check with your local Medicaid office for details.

There are 3 types of Managed Care plans-1) Preferred Provider Organizations (PPOs) which have arrangements with providers. If you stay within the network, your co-pay costs will be lower than if you go outside the network, 2) Health Maintenance Organizations (HMOs) have contracts with providers but you need a referral to a specialist from your primary physician and you generally must stay within the provider list for coverage, 3) Point of Service plans (POS) in which the primary physician usually refers you to other providers within the network. You may go outside the network but will pay a higher percentage than if you choose a participating provider.

You may also have an option for fee-for-service plans, also known as indemnity plans, in which the benefits and costs vary by plan.

There are literally hundreds of options available. You will want to consider the types of services covered, how close are the plan’s providers, how do you feel about limitation in choices of providers, do you need a referral from a primary physician, do you need prior approval, what will your cost be. Existence of a preexisting condition may impact the cost of your coverage.

Websites are available to assist you. MostChoice (www.mostchoice.com) serves as an insurance broker. You can also check the quality of a healthplan at Consumer Assessment of Healthcare Providers and Systems (www.cahps.ahrq.gov) and National Committee on Quality Assurance (www.ncqa.org), and U.S. News and World Report’s annual list of best health plans.