Network type affects how you use care
HMO, PPO, and EPO are common health insurance network types. They can affect which doctors you use, whether referrals are needed, and whether out-of-network care is covered.
The exact rules can vary by plan, so it is important to review the specific plan details instead of relying only on the network label.
HMO plans
HMO plans usually focus on a defined provider network. Many HMO plans require members to use in-network providers except for emergencies, and some may require referrals for certain specialist care.
If you prefer an HMO, check whether your doctors, hospitals, and prescriptions fit the plan before enrolling.
PPO plans
PPO plans may offer more flexibility to see providers outside the network, although out-of-network care can cost more. PPO availability and pricing can vary by market.
Even with a PPO, it is still smart to confirm how your preferred providers are treated under the specific plan.
EPO plans
EPO plans often use a defined network like an HMO, but may not require referrals in the same way. Out-of-network coverage is commonly limited except for emergencies, though details vary by plan.
Provider participation can vary by plan and office location. Always verify participation with the carrier or provider before enrollment.
Check Plans and Networks Side by Side
Compare available ACA plans and review network details before choosing coverage.
Check My Savings