Health Maintenance Organization (HMO)
A health plan in which members select a primary care physician from a panel of participating doctors. The primary care physician helps patients manage their health care and makes referrals for specialty care and hospital services. Services delivered outside the panel of participating providers, or delivered without the primary care physician's referral, must be paid for by the patient.

Preferred Provider Organization (PPO)
A plan in which members receive a higher level of benefits at a lower cost when they choose to have their care delivered by participating physicians, hospitals and other providers. Health expenses are greater when a member receives health services outside the network.

Point of Service Plan (POS)
A combination of an HMO and PPO in which members can use participating health providers for a set fee but also have the choice of going outside of the plan by paying the difference in non-plan benefits.

Exclusive Provider Organization (EPO)
A managed care plan in which enrollees must receive their care from affiliated providers. Treatment provided outside the approved network must be paid for by the patients.

Indemnity Insurance

With indemnity insurance (sometimes called commercial insurance), the patient will pay for all services up to a specified deductible; thereafter, the patient will typically pay a set percentage of the total billed amount.