{"id":996,"date":"2016-11-18T22:43:58","date_gmt":"2016-11-18T22:43:58","guid":{"rendered":"http:\/\/blog.simplyinsured.com\/?page_id=996"},"modified":"2020-03-10T23:13:24","modified_gmt":"2020-03-10T23:13:24","slug":"health-insurance-network-types-ppo-vs-hmo","status":"publish","type":"post","link":"https:\/\/www.simplyinsured.com\/advice\/2016\/11\/18\/health-insurance-network-types-ppo-vs-hmo","title":{"rendered":"Health Insurance Network Types \u2013 PPO vs. HMO vs. EPO vs. POS"},"content":{"rendered":"

One of the most common questions we get at SimplyInsured<\/a> is \u201cWhat is the difference between an HMO and a PPO?\u201d We\u2019ve created a simple table to help understand. First \u2013 some definitions:<\/p>\n

Network Type:<\/strong> A general label for the \u201clevel of restriction\u201d of plan, and the level of coverage provided in-network and out-of-network. Common types include PPO, HMO, EPO, Network, POS, and Indemnity.<\/p>\n

Cliff Notes version:<\/strong><\/h3>\n\n\n\n\n\n
More Restrictions<\/th>\n<\/th>\nFewer Restrictions<\/th>\n<\/tr>\n
\"\"<\/td>\n<\/tr>\n
HMO<\/td>\nEPO<\/td>\n<\/td>\n<\/td>\n  POS       PPO       Indemnity<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Detailed version:<\/strong><\/h3>\n

A few decades ago when health insurance was relatively new \u2013 these terms used to describe clear characteristics about how your plan would pay for doctor\u2019s visits, preventive care, and out-of-network care. Unfortunately, in today\u2019s world \u2013 the lines between plan types has been blurring, and it\u2019s important to check the detailed plan terms to figure out what\u2019s going on. We\u2019ve created a \u201cCheat Sheet\u201d that gives the major implications of each plan type:<\/p>\n\n\n\n\n\n\n\n\n
Network Type<\/strong><\/th>\nIn Network
\nRestrictions<\/strong><\/th>\n		Out Of Network
\nRestrictions<\/strong><\/th>\n<\/tr>\n
Health Maintenance Organization (HMO)<\/strong><\/td>\n\n
    \n
  • Limited network of doctors<\/li>\n
  • Require an assigned Primary Care Physician<\/li>\n
  • PCP must refer you to specialists<\/li>\n<\/ul>\n<\/td>\n
\n
    \n
  • You pay full price if you go out of network (no coverage)<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Exclusive Provider Organization (EPO)<\/strong><\/td>\n\n
    \n
  • Larger group of doctors<\/li>\n
  • No referrals needed to see a specialist<\/li>\n<\/ul>\n<\/td>\n
\n
    \n
  • You pay full price if you go out of network (no coverage)<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Point of Sale (POS)<\/strong><\/td>\n\n
    \n
  • Larger group of accessible doctors<\/li>\n
  • No referrals needed to see a specialist<\/li>\n
  • Discounted copays if you use a dedicated network of doctors<\/li>\n<\/ul>\n<\/td>\n
\n
    \n
  • You will receive some coverage if you go out of network*<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Preferred Provider Organization (PPO)<\/strong><\/td>\n\n
    \n
  • Largest group of accessible doctors<\/li>\n<\/ul>\n<\/td>\n
\n
    \n
  • You will receive some coverage if you go out of network*<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Indemnity<\/strong><\/td>\n\n
    \n
  • Can go to any provider or health care organization<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    *While POS and PPO plans do provide out of network coverage, these services are typically subject to higher deductibles and coinsurance rates, so we always recommend trying to stay in-network wherever possible.<\/p>\n

    If you have any further questions, use the live chat function on your quote to chat with our team of experts!<\/p>\n","protected":false},"excerpt":{"rendered":"

    One of the most common questions we get at SimplyInsured is \u201cWhat is the difference between an HMO and a PPO?\u201d We\u2019ve created a simple table to help understand. First \u2013 some definitions: Network Type: A general label for the \u201clevel of restriction\u201d of plan, and the level of coverage provided in-network and out-of-network. Common…<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_kad_post_transparent":"","_kad_post_title":"","_kad_post_layout":"","_kad_post_sidebar_id":"","_kad_post_content_style":"","_kad_post_vertical_padding":"","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false},"categories":[2],"tags":[],"yoast_head":"\nHealth Insurance Network Types: PPOs, HMOs, and More<\/title>\n<meta name=\"description\" content=\"Read this to understand what the difference between health insurance network types is. PPOs vs. HMOs vs. POS. 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