Plan Networks

"Part of health literacy is understanding key health insurance terms. This will allow for educated decisions when choosing a health insurance plan. In-Network Providers are health care providers who are contracted with your health insurance plan to provide services at a contracted or discounted rate. Out-of-Network Providers are health care providers who are not contracted with your health insurance plan. Out-of-network coinsurance usually costs you more than in-network coinsurance because there is no contracted or discounted rate. Exclusive Provider Organization (EPO) is a managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan’s network, except in an emergency. Health Maintenance Organization (HMO) is a type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness. Point of Service (POS) is a type of plan where you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. POS plans require you to get a referral from your primary care doctor in order to see a specialist. Preferred Provider Organization (PPO) is a type of health plan where you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost."