Medical Plans

A PPO is a medical plan that links select hospitals and doctors to create a network of participating healthcare providers. Under this kind of plan, you’ll pay less if you stay in-network and visit a participating healthcare provider. You can also utilize services at out-of-network healthcare providers for an additional cost, but it’s important to keep in mind that these costs could be significant. Most services under a PPO plan are subject to a copay or an additional fee at the time of service. Some services may also be subject to coinsurance.

This type of medical plan has a higher deductible than traditional insurance plans. While monthly premiums for these plans tend to be less, it is important to remember that all services (except preventive care) will be subject to the deductible first before services are reimbursed. An HDHP is often combined with a Health Savings Account (HSA), a tax-exempt fund that can be used to pay for medical services.

An EPO is a managed care plan which only covers medical care via in-network healthcare providers, unless in an emergency. You do not need a referral from your Primary Care Physician (PCP) to see a specialist. You cannot go out of the plan’s network, except for an emergency (sudden and serious illness).

With a POS plan, you’ll pay less if you utilize services from in-network healthcare providers. There are no referrals required to see a Specialist.