Health Insurance

22 PPO EPO HMO Network You pay less to see providers in your plan’s network. These are called preferred providers. You get covered care from the doctor, hospitals, and other providers in you plan’s network. You get care from the doctors, labs, and other providers in your plan’s network. Out-of- network You can go out-of- network, but you pay more. You cannot see providers out-of- network except in an emergency or if your plan gives you pre- approval. You cannot see providers out-of- network except in an emergency or if your plan gives you pre- approval. Primary care doctor You can choose whether or not to have a primary care doctor. You may not have to use a primary care doctor. You must have a primary care doctor. This is the doctor you usually see first when you need care. Referrals You may be able to get many health services without a referral. You do not need to get referrals to see specialists if they are in the EPO’s network. You need referrals to see specialists or get lab tests. Pre- approval You may be able to get many health services without pre-approval. You may need pre-approval from your health plan before you can get any services. You will need pre-approval from your health plan before you can get many health services. Costs You may have a yearly deductible. You may also have deductibles for hospital care and prescription drugs. Care in the network costs a lot less than care outside the net- work. You usually pay a co-pay or a flat fee for most services. You usually pay a co-pay or a flat fee for most services.