Health Insurance Network Types Explained

When it comes to choosing health insurance, the type of network your plan uses is just as important as your coverage details. A network determines which doctors, specialists, and hospitals you can use—and how easily you can access care.

At Osborne Health Solutions, we believe in making health insurance simple to understand. Here’s a straightforward breakdown of the four most common network types, ranked from most to least flexible:

PPO (Preferred Provider Organization)

PPOs offer the most flexibility when it comes to choosing healthcare providers.

• You can see any doctor or specialist without a referral

• Both in-network and out-of-network providers are covered

• You’re not required to choose a primary care doctor

• Ideal for those who want control over who they see and when

• Great for frequent travelers or individuals who see multiple specialists

EPO (Exclusive Provider Organization)

EPOs are structured, but still allow for direct access to specialists within the network.

• No referrals needed to see specialists

• Only covers care within the network (except for emergencies)

• You don’t need to select a primary care doctor

• Works well if you’re comfortable staying within a defined group of providers

• A good fit for those who want access without the need for referrals

HMO (Health Maintenance Organization)

HMOs focus on coordinated care through a single point of contact.

• Requires you to choose a primary care physician (PCP)

• You’ll need a referral from your PCP to see specialists

• Only covers in-network care (except emergencies)

• Encourages consistent care through one doctor who manages your health

• Best for those who prefer having one provider coordinate all care

POS (Point of Service)

POS plans blend features of PPOs and HMOs but with added structure.

• You must choose a primary care physician (PCP)

• Referrals are required to see specialists

• You can go out-of-network, but only with a referral

• Offers flexibility with added coordination

• May suit those who want the option to go out-of-network but still prefer a guided approach

How to Choose the Right Network Type

There’s no single “best” network—it depends on your personal preferences and healthcare habits. Consider:

• How important provider flexibility is to you

• Whether you’re comfortable coordinating care through a PCP

• If you travel often or need access to out-of-network doctors

• How often you visit specialists or receive ongoing treatment

At Osborne Health Solutions, we help you weigh all these factors and find the plan that’s right for your life—not just what’s written in the brochure.