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Health Plans
EPO
An EPO is an Exclusive Provider Organization. EPO
plans are more restrictive than other plans in terms of
benefits. Benefits are only available within the network.
The plan does not require a referral for specialist visits.
Basically, you are required to stay within the network.
PPO
The Preferred Provider Organization is called a PPO. As
opposed to other types of plans, these usually have a
larger provider network. By staying within the network,
you will receive maximum benefits. Although you won't
receive as much coverage when you go out of network,
you will still receive some benefits. You can see a
specialist without a referral from a primary care
physician (PCP) when you have a PPO plan. A plan like
this is ideal if you travel a lot, want more options for
doctors, or don't want to need a referral every time you
see a specialist.
HMO
Health Maintenance Organizations are called HMOs.
Medical providers who are contracted with the
insurance company make up this type of health care
plan. Benefits are only provided if you stay within the
network unless you have a real emergency. They will
provide a list of primary care physicians (PCPs) in their
network. A referral from your PCP is required if you need
to see a specialist