EPO plans are similar to HMOs with designated physicians and medical facilities except in emergencies. Members have a PCP

Members can have lower Out-of-Pocket expenses but less flexibility in medical professionals and facilities. Members usually have to pick a primary care physician (PCP) or one is assigned, and a referral must be obtained before seeing a specialist.

HMOs typically won’t allow out-of-network care unless it’s an emergency.

HRS is an IRS-approved, employer-funded health benefit that allow employers to reimburse employees for qualifying insurance premiums and out-of-pocket expenses.

HSAs are tax-advantaged savings accounts, normally paired with a high deductible health plan (HDHP) to cover qualifying medical charges.

HSA Contributions have certain limits set by the IRS and are made

These are fee-for-service plans. The insurance company pays a predetermined percentage of a reasonable and customary approved fee schedule within a geographical area for a given service and the insured pays the balance.

The is no provider network, patients are free to choose any medical professional and facility. Fees for services are determined by the providers, potentially creating large medical bills.

Point-of-Service health plans combine HMO and PPO features.

Members may need to choose a PCP from the network, and visits to a PCP may not be subject to a deductible. Services rendered or referred by PCP may have a higher level of coverage.

Visits to out-of-network providers may be subject to a deductible, reduced level of coverage, and up-front payments at the time of service, and claims can be submitted for reimbursement.

Members have access to a network of preferred medical professionals and facilities which have agreed to a negotiated or discounted rate. Generally, members can see any doctor within their network to control costs. They may or may not need to select a primary care physician (PCP).

Members who choose to seek care with an Out-Of-Network Provider are responsible for all expenses not allowed, covered, or denied by the insurance plan.

There may be an annual deductible to meet before the insurance begins to cover claims.

There may be a copayment or co-insurance. Out-of-Network (OON) care typically results in higher out-of-pocket costs.