HMO: Health Maintenance Organization
HMO plans are the most restrictive type of plan when it comes to accessing your network of providers. If you have an HMO plan, you’ll be asked to choose a primary care physician (PCP) that is in-network. All of your care will be coordinated by your PCP any out-of-network health care costs.
HMO plans typically have cheaper premiums than other types of private health insurance plans.
PPO: Preferred Provider Organization
PPO plans are the least restrictive type of plan when it comes to accessing your network of providers and getting care from outside the plan’s network. Typically, you have the option between choosing between an in-network doctor, who can you see at a lower cost, or an out-of-network doctor at a higher cost. You do not need a referral to see a specialist, though you may still choose a primary care physician (some states, like California, may require that you have a primary care physician).
PPO plans typically have more expensive premiums than other types of private health insurance plans.
EPO: Exclusive Provider Organization
EPO plans are a mix between HMO plans and PPO plans. EPO plans give you the option of seeing a specialist without a referral. However, EPO plans do not cover out-of-network physicians.
EPO plans typically have more expensive premiums than HMOs, but less expensive premiums than PPOs.
POS: Point of Service
POS plans are another hybrid of HMO and PPO plans. You’ll have a primary care provider on an HMO-style network that can coordinate your care. You’ll also have access to a PPO-style network with out-of-network options (albeit at a higher cost). The HMO network will be more affordable, and you will need to get a referral to see HMO specialists.
POS plans typically have more expensive premiums than pure HMOs, but less expensive premiums than PPOs.
