You’ve no doubt seen the letters HMO, PPO or EPO after a health plan name. Here’s a quick explanation of what those letters mean, and how these plans differ from each other.
HMO – Health Maintenance Organization
- Requires you to select a Primary Care doctor
- Usually requires referrals to see a specialist
- Covers In-network care only, except for emergencies
- Usually chosen for lower costs
PPO – Preferred Provider Organization
- Usually does NOT require you to select a Primary Care doctor
- No referrals to see a specialist
- Covers both in-network and out-of-network care; Costs for out-of-network may be higher
- Usually chosen for maximum provider choice and flexibility
EPO — Exclusive Provider Organization
- Requires you to select a Primary Care doctor
- Usually does NOT require referrals to see a specialist
- Covers In-network care only except for emergencies
- Usually chosen for lower costs