What’s the difference between HMO, PPO and EPO plans?

In an HMO, you choose a family doctor, called a primary care physician (PCP), who provides the services you need. Your PCP refers you to other doctors or health care providers within the HMO network when you need specialized care. Typically, only emergency services are covered if you go outside of the plan network. HMOs usually have the lowest premiums. 

In a PPO, you don’t have to choose a primary care physician (PCP), and you can go to doctors in or out of the health plan’s network. You can see doctors, hospitals, and other health care providers of your choice, such as a heart doctor, but you will pay more if your doctor does not participate in your health plan’s network. PPOs tend to have higher premiums than HMOs.

Another term you might here is EPO - it stands for "Exclusive Provider Organization" plan. As a member of an EPO, you can use the doctors and hospitals within the EPO network, but cannot go outside the network for care.  The network is usually broad, like a PPO, with many provider choices, but limited to those providers with no out-of-network benefits. The premiums are generally lower for an EPO because of the limit on out-of-network benefits.

Watch the two videos below to learn about the differences between HMO and PPO plan types:
#117 R11/13/17