Health Maintenance Organizations
(HMOs)
• The least freedom to choose your health care providers
• The least amount of paperwork compared to other plans
A primary care doctor to manage your care and refer you to specialists when you need one so the care is covered by the health plan; most HMOs will require a referral before you can see a specialist.
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Preferred Provider Organizations
(PPOs)
Preferred provider organizations are a type of health plan. PPOs have a network of doctors, hospitals, and other providers who have agreed to charge less for plan members. Members of the health plan have access to a list of providers in the network by name and location. Generally with a PPO, you do not need a referral from your primary care provider when you want to see a specialist. With PPO coverage, you may also choose to seek care from providers that do not participate in the plan's network. However, going outside the network comes with additional costs.
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Exclusive Provider Organizations
(EPOs)
An exclusive provider organization, or EPO, is a health insurance plan that only allows you to get health care services from doctors, hospitals, and other care providers who are within your network. Your insurance will not cover any costs you get from going to someone outside of that network. The only exception is that emergency care is usually covered.
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Point-Of-Service
(POS)plans
A POS health plan stands for "point of service" and is a mix between an HMO and a PPO-style health insurance policy. With a POS health plan, you have more choices than with an HMO. You may need to select a primary care provider and need a referral to see a specialist. But with a POS plan you have the choice to use doctors, hospitals, and other providers that are not in your health plan's network. However, you will have to pay more for using out-of-network providers.
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