Health Insurance

Health Plan Types Comparison Chart

Cost?
What will I pay?
If I use out-of-network providers, will my care be covered? (In the case of emergencies and when care is not available in-network, out-of-network providers should be covered.)
Do I have to designate a primary care physician (PCP)?
Do I need a referral to see a specialist?
This plan is best for people who:
Health Maintenance Organization (HMO)
Usually the lowest cost of all plans.
  • Premium
  • Copay
  • Deductible
  • No
    Yes
    Yes
  • are on a tighter budget
  • have few medical issues
  • are fine going to their PCP for all health services
  • Exclusive Provider Organization (EPO)
    Usually lower cost than a PPO.
  • Premium
  • Copay or coinsurance
  • Deductible
  • No
    No
    No
  • have price flexibility
  • do not want to designate a PCP
  • Preferred Provider Organization (PPO)
    Usually the highest cost of all plans.
  • Premium
  • Copay
  • Coinsurance
  • Yes, but you will pay a higher percentage of the cost if you go out-of-network.
    No
    No
  • have price flexibility
  • require more medical care
  • want freedom to choose any doctor, specialist, or hospital
  • Point-of-Service (POS)
    Usually lower cost than a PPO.
  • Premium
  • Copay
  • Sometimes coinsurance
  • Deductible
  • Yes, but you will pay a higher percentage of the cost if you go out-of-network.
    Usually
    Usually
  • are on a tighter budget
  • want the option to go to out-of-network doctors or specialists