Plan types
HMO (Health Maintenance Organization)
A health plan that requires you to use providers in its network and get referrals from a primary care physician (PCP) for specialist visits. HMOs have lower premiums than PPOs but less flexibility. Out-of-network care is generally not covered except in emergencies. Best for people who want lower costs and don't mind designating a PCP.Last reviewed: · TMRW Benefits is a benefits brokerage, not a tax or legal advisor. Consult a CPA or attorney for situation-specific guidance.
Related terms
PPO (Preferred Provider Organization)
See any provider, no referrals. Broadest networks.
Read definitionEPO (Exclusive Provider Organization)
In-network only, but no referrals required.
Read definitionPCP (Primary Care Physician)
Main doctor coordinating care. Required for HMOs.
Read definitionIn-network
Providers contracted with your insurer at negotiated rates.
Read definitionMore in Plan types
PPO (Preferred Provider Organization)
See any provider, no referrals. Broadest networks.
EPO (Exclusive Provider Organization)
In-network only, but no referrals required.
POS (Point of Service)
Hybrid HMO/PPO. Requires PCP but covers some out-of-network.
HDHP (High-Deductible Health Plan)
Higher deductible, lower premium. Pairs with an HSA.
Catastrophic plan
Low-premium ACA plan for under-30s or hardship-exempt.
Short-term medical
Bridge coverage. NOT ACA-compliant.
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