Platform Availability
Establishing & Understanding the Difference between Networks
The type of network you choose will determine which providers you can see.
Providers include
- Doctors
- Specialists
- Pharmacies
- Hospitals
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)