All Health Insurance Plan Types

HMO, PPO, EPO, POS: The Real Differences

The two questions that separate them

Every plan type is an answer to two questions: do you need a referral to see a specialist, and does the plan pay anything out of network?

• HMO: referrals required, no out-of-network coverage. Cheapest, most structured.
• PPO: no referrals, out-of-network partially covered. Most freedom, highest cost.
• EPO: no referrals, but in-network only. A popular middle ground.
• POS: referrals required, some out-of-network coverage. The least common hybrid.

How to pick in practice

If you have doctors you refuse to lose, start from their networks and work backward. If you have no strong attachments, an HMO or EPO usually buys the same care for less money. We check your exact doctors against real networks before recommending anything.