Understanding and comparing the various health insurance plan types (PPO, HMO, POS and EPO) can be confusing! Here is a simple comparison:
| Comparison of Different Types of Plans | |||
| Type of Plan | Required to stay in-network? | Are referrals required for specialists and procedures? | This plan type |
| HMO: Health Maintenance Organization | Yes, except for emergencies. | Yes | reduces lower out-of-pocket costs if you like your primary doctors and the in-network specialists and facilities |
| PPO: Preferred Provider Organization | No, but you get the lowest costs by staying in-network | No | is better if the doctors and facilities you want are not in an HMO network. Best for rural areas where there are few choices of doctors, which may force your to go out of netwrok |
| EPO: Exclusive Provider Organization | Yes, except for emergencies. | No | Does not require referrals but does lower out-of-pocket costs |
| POS: Point of Service Plan | No, but it is cheaper to stay in network and you do need a referral to go out of network. | Yes | Like the PPO, it gives your more flexibility in doctors and facilities, but your primary doctor coordinates your care for you, including ordering tests and working with your specialists. |