8/21/2025
HMO – Health Maintenance Organization
Best for: People who don’t mind a more restricted network to save money.
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You must use in-network providers (except in emergencies).
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You need a primary care doctor (PCP) and a referral to see most specialists.
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Usually lower premiums, but less flexibility if you want to see a doctor outside the network.
EPO – Exclusive Provider Organization
Best for: People who want lower costs but still some PPO-like freedom.
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Only covers in-network care (except emergencies).
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No referrals needed for specialists.
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Good balance of cost and flexibility—if your doctors are in the network.
POS – Point of Service
Best for: People who want HMO structure with some out-of-network coverage.
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You need a primary care doctor and referrals for specialists.
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Can get out-of-network care, but at a higher cost.
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Often works well if you’re in-network most of the time but need occasional access to providers outside the network.
The Bottom Line
Choosing the right network type can save you thousands—and prevent surprise bills.
If you travel often, need flexibility, or have preferred doctors, a PPO or POS might be worth the higher premium.
If cost is your top concern and your doctors are in-network, HMO or EPO could be the better fit.
💡 Pro Tip: Before picking a plan, make sure your doctors and specialists are in-network for the exact network name your plan uses—not just the insurance company.
If you’re unsure which type makes sense for your lifestyle and budget, I can help you compare.
📞 Call or text 716-503-1113 and let’s find the right fit for you.