PPO plans give you the flexibility to receive care from any in-network or out-of-network provider. But your costs are generally lower when you use providers inside a designated network of providers. Some services require a deductible to be met before a “coinsurance” or percentage of cost is applied, while other services may only require a “copay” or flat-dollar amount be paid.

HDHPs often offer lower premiums in exchange for a higher deductible that must be met before the plan begins to cover eligible services. However, in-network preventive services are covered at 100%. Because HDHPs have a higher deductible, you have the option to contribute to (or, if applicable, receive company contributions to) a health savings account (HSA), which lets you set aside pre-tax money to pay for eligible health care expenses.

HMO plans offer care through a network of providers, but no benefits are paid for care received outside the HMO plan’s network (except in emergencies). For many services, you pay a flat fee called a “copay.” And with some HMO plans, you must first meet an annual deductible and pay coinsurance for certain services. Also, some HMOs require you to get referrals from your primary care physician (PCP) to access specialists and other providers in the HMO plan’s network.

EPO plans are similar to HMOs. They offer care exclusively through in-network providers (no benefits are paid for care received outside the EPO plan's network, except in emergencies). However, you do not need referrals from your PCP to access specialists and other providers in the EPO plan's network.

A POS plan is an HMO/PPO hybrid. POS plans resemble HMOs for in-network services, requiring only a copayment from the member. Services received outside of the network are usually reimbursed in a manner similar to PPO plans (e.g., provider reimbursement based on a fee schedule or usual, customary and reasonable charges).

A group of hospitals, primary care and specialty physicians and other health care providers involved in patient care who work together voluntarily to give coordinated care to their patients.