These describe how a plan manages access to providers. An HMO requires a primary care physician and referrals and generally covers only in-network care; a PPO is the most flexible (no referrals, some out-of-network coverage); an EPO covers only in-network care but skips referrals; and a POS plan blends HMO and PPO features.
HMOs
HMO stands for Health Maintenance Organization. It’s a type of health plan that usually has a smaller provider network than a PPO and provides no out-of-network benefits other than emergency care. HMOs usually require a Primary Care Physician (PCP) and referrals to see a specialist.