Network Types

Establishing & Understanding the Difference between Networks

The type of network you choose will determine which providers you can see.

Providers include

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HMO (Health Maintenance Organization)
  • Usually limit coverage to
  • Providers within the plan’s network, normally local
  • REQUIRE a doctor’s referral to see specialists
PPO (Preferred Provider Organization)
  • Usually cover
  • Some of the cost of out-of-network providers
  • DO NOT require a doctor’s referral to see specialists
EPO (Exclusive Provider Organization)
  • Hybrid of HMO & PPO plans
  • Usually limit coverage to
  • Providers within the plan’s network, normally local
  • DO NOT require a doctor’s referral to see specialists
POS (Point of Service)
  • Hybrid of HMO & PPO plans
  • You MUST choose an in-network Primary Care Provider (PCP)
  • Can see an out-of-network provider WITHOUT your PCP’s referral (higher cost)

Here at Dave Knows Health®, Dave understands health coverage isn’t the easiest to understand. Dave strives to make it as easy as possible for Americans to comprehend & obtain.

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