Health insurance comes in various types, and the jargon can often be confusing. How do you know if you need a PPO plan or an HMO plan? Would an EPO serve your needs, or should you opt for a POS plan? This blog from Champion Insurance Agency explains the difference between these health insurance types so you can make an informed decision.

Health Maintenance Organizations (HMOs)

An HMO provides comprehensive care within its own network. You choose your South Carolina primary care physician (PCP), but you’ll pay a co-pay at each appointment. This co-pay applies to visits to a specialist, too. HMOs don’t usually charge a deductible or co-insurance for hospitalization. The HMO provides a benefits summary when you purchase the insurance, and it specifies everything that the plan covers.

Preferred Provider Organizations (PPOs)

Choosing a PPO lets you see in-network and out-of-network medical providers. Medical services cost less when you remain in-network. If you don’t have a PCP, you don’t have to choose one. Some PPOs let you visit a specialist without a referral. They cost a little more for the premiums and the co-pays, but you obtain greater choices.

Exclusive Provider Organizations (EPOs)

An EPO only covers services from in-network providers, except for emergency services. In an emergency, your EPO plan covers any provider. With this type of plan, you don’t have to pick a PCP and don’t need a referral to visit a specialist.

Point-of-Service (POS)

Health insurance using the POS method lets you pick a PCP within the plan’s network. Under any circumstance, you can seek care outside the plan network. Some services by specialists require a referral. When you go outside the network, you pay the medical service costs, unless your PCP refers you to the specialist.

Contact Us Today to Choose Your Health Insurance

Champion Insurance Agency wants to help its South Carolina customers make better insurance purchase decisions that serve their medical needs. Let us help you decide which type of health insurance best serves your needs. Contact us today.