What does the EPO, PPO, HMO, POS stand for in HEALTH INSURANCE? What is network provider?


Welcome back to my channel Let’s Talk Money. Today I would like to explain the network
types most commonly known as EPO’s, PPO’s, HMO’s and POS plans. Some plan types allow you to use almost any
doctor or health care facility. Others limit your choices or charge you more
if you use providers outside their network. You can easily identify the type of plan by
looking at the description next to the plan name. Let’s look at each network type. • Preferred Provider Organization (PPO):
PPOs give you the choice of getting care from innetwork or out-of-network providers. You pay less if you use providers that belong
to the plan’s network. You’ll pay more if you use doctors, providers,
and hospitals outside of the network, and you may have higher out-of-pocket costs for
services. If you have a PPO plan, you can visit any
doctor without getting a referral. • Exclusive Provider Organization (EPO):
A managed care plan where services are covered only if you use doctors, specialists, or hospitals
in the plan’s network (except in an emergency). No referral is required to see a specialist •
Point of Service (POS): A type of plan where you pay less if you use doctors, hospitals,
and other health care providers that belong to the plan’s network. POS plans require you to get a referral from
your primary care doctor in order to see a specialist. • Health Maintenance Organization (HMO):
A type of health insurance plan that usually limits coverage to care from doctors who work
for or contract with the HMO. An HMO generally won’t cover or has limited
coverage for out-of-network care except in an emergency. If you use a doctor or facility that isn’t
in the HMO’s network, you may have to pay the full cost of the services you get. HMO members usually have a primary care doctor
and must get referrals to see specialists. We’ve been talking so much about provider
networks, SO what is that? Well, a provider network is a list of the
doctors, other health care providers, and hospitals that a plan has contracted with
to provide medical care to its members. These providers are called “network providers”
or “in-network providers.” A provider that hasn’t contracted with the
plan is called an “out-of-network provider.” Please subscribe to our channel! Don’t forget to share your happiness!

1 comment

Leave a Reply