But, like a PPO plan, you will pay less if you use doctors, hospitals, and other healthcare providers in the plan’s network, and you will have access to out-of-network providers at an increased cost. Like an HMO, you will need a referral from your PCP in order to see a specialist. An EPO is a good option if you want to see specialists without a PCP referral within your network.Ī POS (or "point of service”) plan is also a hybrid of an HMO and PPO plan. But like an HMO, you are responsible for paying out-of-pocket if you seek care from a doctor outside your plan's network. Like a PPO, you do not need a referral to get care from a specialist. Gain access to health- and wellness-related deals on fitness products, gym memberships, healthy eating and more. EPOs generally offer a little more flexibility than an HMO and are generally a bit less pricey than a PPO. With a PPO, you will have access to out-of-state providers that are considered in-network.Īn EPO (or “exclusive provider organization”) is a bit like a hybrid of an HMO and a PPO. Explore our medical, dental, and Medicare health care plans. If you choose to see a doctor who is outside the preferred network, you will generally have to pay a larger portion of the bill than you would for an “in-network” provider, but most plans will still cover a portion of the bill. Florida Blue offers affordable health insurance plans to individuals, families, and businesses. If you see a “preferred” (or “in-network”) provider, you will only be responsible for paying a portion of the bill (according to your plan's coverage structure). Horizon BCBSNJ: State Health Benefits Program- NJ DIRECT 2035 (PPO) Coverage for: All Coverage Types Plan Type: PPO (NJ DIRECT (PPO))/BlueCard 1 of 9 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. You do not need to select a primary care physician and you do not need referrals to see a specialist. A PPO (or “preferred provider organization”) is a health plan with a “preferred” network of providers in your area.
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