Find Health Plans TodaySpeak to an agent now
← Home Plan types · 4 min read

HMO, PPO, EPO: which plan type fits how you get care

The plan type decides whether you need referrals and whether out-of-network care is covered. A plain-English comparison.

The letters on a plan tell you how it works day to day: who you can see, whether you need a referral, and what happens outside the network.

The main types

  • HMO: care usually from in-network doctors only, and you often need a referral from your primary doctor to see a specialist.
  • PPO: you pay less in-network, but you can usually see out-of-network doctors for more, often without a referral.
  • EPO: in-network only, except emergencies, but usually no referral needed for specialists.

Which fits you?

  • Keeping specific doctors who may be out of network? A PPO may fit.
  • Happy with one primary doctor coordinating your care? An HMO can work.
  • Want specialists without referrals but don't need out-of-network care? Look at EPOs.

Sources: HealthCare.gov: health plan types · referral

Want someone to check this for you?A licensed agent can go through your doctors, prescriptions and total yearly cost with you.Speak to an agent now

More guides