Differences between HMO, EPO and PPO health insurance

Have you ever wondered what the difference is between health insurance in Florida HMO, EPO and PPO? At Sebanda Insurance we want you to have clear information so that you can choose the best option for you and your family, not only for coverage, but also for prices. Let us begin.

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What is HMO health insurance?

Better known as a Health Maintenance Organization or Health Maintenance Organization, it is a type of health policy that offers users the possibility of accessing a complete local network of doctors and hospitals so that they can choose the one of their choice. 

It is a well-known type of health insurance in Florida as it offers lower monthly premiums compared to PPO or EPO health plans. It is important to clarify that in general, HMO medical insurance does not cover services outside of its network and it is the general practitioner who refers patients to the different specialties.

This is one of the plans most used by Obamacare beneficiaries precisely because of its cost/benefit ratio.

What is PPO health insurance?

Named as Preferred Provider Organizations, this health insurance is more expensive than the others and to the same extent, it offers a larger network of providers to its users. 

People who purchase this type of policy will obtain special benefits with the possibility of accessing top-ranking doctors and hospitals, and in addition to that, they will be able to obtain specialty services without having to go through a general practitioner. 

The beneficiaries will even be able to leave the insurance network and attend wherever they want, but clearly not all expenses will be covered by the policy.

What is EPO health insurance?

Also known as Exclusive Provider Organization, it is the type of health insurance that is in the middle of the HMO and the PPO, since it can offer cheap monthly prices like the HMO does, but it is much more flexible if we talk about the network of doctors and hospitals, and care with specialists, since it should not be referred by a primary care physician.

It is generally recommended for users who live in rural areas, because it can be more difficult to find a medical center or specialist nearby, and in an emergency a broader network is needed.

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One point to clarify is that it does not cover services that are outside the network.

Some frequently asked questions about HMO, EPO and PPO health insurance

How does coverage work inside and outside the network?

In Florida whenever you need medical attention, you will have the option to do so by choosing a doctor or hospital within the network and outside it, what does that imply? That if you decide to do it with those that are within the network of your health plan, you will receive all the coverage and you will also have lower out-of-pocket costs. This is because providers have agreed to charge lower rates and cover most needs.

Conversely, if you choose to visit a doctor outside the plan’s network, your out-of-pocket costs will be higher and there’s a good chance your policy won’t provide the coverage you need.

Does this medical insurance cover hospitalization?

Yes, in an emergency situation that requires hospitalization, the medical insurance you have must cover these services. However, non-emergency stays must be scheduled in advance.

Where can I buy HMO, EPO and PPO health insurance in Florida?

In Florida there are several medical insurance options , but if you want to find an insurance company that really helps you find the option that best suits you and that takes care of your pocket, choose Sebanda Insurance , you will not only get the best coverage it will also save a lot of money.

Request your free quote now and find out. Remember that in our blog we have other articles of interest, we invite you to see them so that you are always updated with the best information in the world of insurance in the USA.

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