What are the different types of health insurance plans?

There are four main types of health insurance plans available in California: HMOs, PPOs, EPOs, and POS plans. A Health Maintenance Organization (HMO) is a type of plan that typically has the lowest premiums and offers the least flexibility. With an HMO plan, the members of the plan receive care from providers that are part of the plan’s network and referrals are required for any out-of-network care. A Preferred Provider Organization (PPO) plan offers more flexibility than an HMO in that members can receive care from in-network and out-of-network providers without a referral. However, out-of-network care will typically be more expensive than in-network care. An Exclusive Provider Organization (EPO) plan is similar to an HMO in that members receive care from in-network providers only and referrals are required for out-of-network care. However, an EPO does not usually require members to select a primary care physician like an HMO does. A Point-of-service (POS) plan combines aspects of both HMOs and PPOs. With a POS plan, members can receive care from in-network providers without a referral and can receive out-of-network care with a referral. However, out-of-network care is usually not covered. Each type of plan has its own advantages and disadvantages and it is important to understand the differences before choosing a plan to make sure that it meets the individual’s or family’s needs.

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