Module 1 · Lesson 2 of 4
What Type of Plan Do You Have?
There are five types of health insurance plans. Each one changes the rules for which doctors you can see and how much you pay.
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The Five Plan Types
HMO
Lowest premiums, must stay in-network and get referrals from your primary care doctor
PPO
Highest premiums, see any specialist without a referral and have out-of-network coverage
EPO
Middle-range premiums, no referrals needed but must stay in-network except emergencies
POS
Medium to high premiums, need referrals like HMO but can go out-of-network like PPO
HDHP
Any of the above with a high deductible that unlocks a Health Savings Account with triple tax benefits
Infographic: Plan Types at a Glance
See It In Action: PPO vs. HMO
Consider two plans offered by the same employer. The difference in what you actually pay can surprise you:
Monthly premium: $450 — higher cost for flexibility
vs.
Monthly premium: $350 — lower cost, network restrictions
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PPO costs $1,200 more per year in premiums alone
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The Real Question
Do You Use That Flexibility?
If you see your doctor twice a year and rarely go out-of-network, the HMO gives you the same care for $1,200 less.
Check Your Understanding
Knowledge Check
Which plan type typically has the lowest premiums but requires you to stay in-network and get referrals?
Not quite. The HMO has the lowest premiums of all plan types because it restricts your choices — you must stay in-network and get referrals. That lower cost is the trade-off for less flexibility.
Do This Now
Check your insurance card or call the number on the back. Ask: What type of plan do I have? Is it an HMO, PPO, EPO, POS, or HDHP? Write it down next to the four numbers you identified in Lesson 1.1. You’re building your insurance literacy one number at a time.
About This Lesson
This lesson is part of How Your Insurance Actually Works — an evidence-based course designed with clinical expertise by the AnchorWellPress medical team. This content is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult your healthcare provider.