HMO vs PPO vs POS Plans | In-Network & Out Of Network benefits |Medical billing in Tamil|AR CALLER| VBILLING V BILLINGS

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HMO: Health maintenance organization: Budget-friendly plan.

It is one of the cheapest types of health insurance. It has low premiums and the deductible and fixed copay for doctor visits.

HMO is an individual plan.

In this policy, a PCP (Primary Care Physician) will be allocated.

HMO requires referral# from PCP when patient referred to get treated by a Specialist.

It covers only In-Network benefits, Out of network benefits not available.



POS: Point-of-Service: Hybrid of HMO and PPO

POS is one of the cheapest types of health insurance. It has low premiums and the deductible and fixed copay for doctor visits.

POS is an individual plan.

PCP (Primary Care Physician) will be allocated in POS,

Requires referral from PCP when patient referred to a Specialist.

Both In-Network benefits and Out of network benefits available.



PPO: Preferred Provider Organization: A high premium plan but fewer patient responsibilities.

PPO is one of the costliest types of health insurance. It has higher premiums than HMO and POS plan type. Copay and Coinsurance for in-network doctors are low.

PPO is a group policy.

PCP (Primary Care Physician) and Referral not needed.

A patient can directly meet Specialist

Both In-Network benefits and Out of network benefits available.



EPO: Exclusive Provider Organization: Lower monthly premiums but a higher deductible

If you’re looking for lower monthly premiums and are willing to pay a higher deductible when you need health care, you may want to consider an EPO plan.

EPO is a group plan

PCP (Primary Care Physician) and Referral not needed.

A patient can directly meet Specialist

It covers only In-Network benefits. Out of network benefits not available.