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It might be a lot simpler if there were only one type of health insurance plan, but it wouldn't necessarily be better for you. Having options means it's easier to find a plan that fits your needs—both for your health and your budget. And don't worry—we'll help you figure out the differences between plans. You'll see it's really not so complicated once you take a closer look. Here's a brief description of the three main types of managed care plans:

HMO: Health Maintenance Organization

  • You choose a
    primary care provider (PCP)The doctor or nurse practitioner who coordinates your health care and is usually the first person you see for any medical problem.
    from within a health plan's network
  • Your PCP coordinates all your care and refers you to medical specialists when needed
  • Low
    out-of-pocket expensesMoney paid—out of your own pocket—towards your care. This includes copayments, co-insurance, and/or deductibles paid for covered services.
    , as long as your doctors and hospitals are members of your HMO plan's network

POS: Point-of-Service

  • You choose a PCP within your health plan's network to coordinate your care
  • You don't need a PCP referral to see a specialist, as long as the doctor is within your plan's network; Costs will be higher without the PCP referral
  • Your costs are higher when you go outside your network
  • No
    deductibleThe amount you need to pay out of your pocket before health care benefits are paid by insurance.
    when you coordinate your care with your PCP

PPO: Preferred Provider Organization

  • Greater flexibility than an HMO
  • You have a network of doctors to choose from, but don't need to name one doctor as your PCP
  • If you use doctors and hospitals from outside of your PPO network, it may cost more
  • You do not need a referral from your PCP to see a specialist
  • Your out-of-pocket health care costs may be higher
  • Some plans have deductibles before benefits are paid; amount varies between plans
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