What is a HMO PPO and EPO - Nevada Health Link Las Vegas Henderson Nevada

 

The Nevada Health Link partnered with five health insurance carriers this year. Anthem (Blue Cross Blue Shield), Ambetter, Health Plan of Nevada, Friday Health Insurance and Select Health. We're contracted with Anthem, Ambetter and Friday Health Insurance. Each carrier will provide plans under a HMO or EPO network. The past five years Nevada offered only HMO plans. Consumers complained about the lack of options regarding health insurance. In result, the Nevada Health Link now offer EPO plans. 

In this article, I'll explain the difference between all three health insurance networks. HMO, EPO, and PPO (which isn't offered via the Nevada Health Link.)

What is a HMO Provider Network?

A Health Maintenance Organization is a provider network with it's own Doctors and Hospitals. HMO health plans are restricted to it's own network. One is free to find a primary care physician, however a referral is required for a HMO network specialist. With such restrictions, typically a HMO network will provide lower deductibles, out of pocket costs and premiums. It is important to realize plans vary by carrier.

What is an EPO Provider Network?

An EPO Network is similar to HMO and PPO networks. An Exclusive Provider Organization health plan may contain less co pay benefits, while providing major catastrophic hospital coverage. An EPO network has it's own network and doctors on a local bases, similar to an HMO. However similar to a PPO network, one has flexibility within an EPO network. Both EPO and HMO networks typically have no out of network coverage.

What is a PPO Network?

A Preferred Provider Organization is a network with plenty of Doctor and Hospital flexibility. A PPO network will provide coverage for in and out of network, premiums are typically higher than an HMO and EPO plan. In addition to flexible choices, specialist doctors require no referrals. 

While health insurance can be confusing, we're here to assist and education the consumer. 

Should you have questions. Call us at 702.763.3590 or submit your contact information here for an appointment.