What’s the difference between an HMO, PPO and EPO?

Health plans sold through Covered California fall in these three categories. They differ when it comes to things like costs and provider networks (the doctors, hospitals, labs, and so on that your plan covers).  

HMOs (health maintenance organizations) are typically cheaper than PPOs, but they tend to have smaller networks. You need to see your primary care physician before getting a referral to a specialist. 

PPOs (preferred provider organizations) are usually more expensive. In exchange, you will likely get a larger network and the ability to see a provider outside that network. You can also see specialists without a referral. 

EPOS (exclusive provider organizations) combine features of HMOs and PPOs. They have exclusive networks like HMOs do, which means they are usually less expensive than PPOs. But as with PPOs, you’ll be able to make your own appointments with specialists.