POS vs EPO Health Insurance Plans

Comparing and Contrasting a  POS and EPO Health Insurance Plan

 

Two more types of health insurance plans are a POS and EPO. Below are some of their similarities and differences. 

 

POS: A POS-- Point-of-Service-- plan is really a combination of an HMO and PPO plan. Like an HMO, it requires referral from your primary care provider to find and visit a specialist. However, for premiums that are slightly higher than an HMO, it will cover out of network doctors. When you visit doctors that are in-network, it will be a lower out-of-pocket cost. 

 

EPO: An EPO-- exclusive provider organization-- is one of the lesser known plans. These plans will only cover care that is in-network. However, this network is larger than those for an HMO plan. With an EPO, it is not required to get a referral from your primary care provider to see a specialist. If you choose to see somebody who is out-of-network, you will have to cover all of the costs on your own. The only exception to this rule is if it were to have been an emergency visit. 

 

Those who are looking for an affordable plan that has some out of network coverage should enroll into a POS plan. Those who want a larger network should choose an EPO. An EPO network is often national, so even if you are traveling away from home, you will most likely find a provider who is in the network. An EPO does not require the planholder to file claim paperwork at all, whereas the POS requires claim paperwork for out-of-network claims only. If you would like to have lower costs with no specialists referrals, an EPO is probably the best choice for you. Use Nayya to help find the best insurance plan for you.