Health insurance alphabet soup

Learning words used in the health insurance industry is helpful when shopping and choosing a health insurance plan.

What is an EPO, a PPO or a POS? These are all examples of terminology used in the Health Insurance Marketplace to describe different types of health insurance policies. Part of the confusion of understanding health insurance options is to be able to navigate through the terminology. Help is available to learn the jargon! Plan to attend one of the online webinars now offered every Monday by Michigan State University Extension.

For individuals and families, webinars are offered three times every Monday from 9 - 11 a.m., 3 – 5 p.m. and 6 – 8 p.m. For farmers, self employed people and small business owners, join the webinar from noon to 2 p.m. All times are Eastern time. Pre-registration is not necessary, just log on to http://connect.msu.edu/healthinsurance. Click “Guest” and type in any name. (You will be anonymous.) Don’t have a computer with a high-speed connection? Visit your local library for access.

Now to get back to the alphabet soup. An EPO (similar to an HMO) is an Exclusive Provider Organization. This is a managed care plan where health services are covered only if you go doctors, specialists or hospitals in the plan’s network (except in an emergency).

A PPO or Preferred Provider Organization is a type of plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan’s network but you can use doctors, hospitals and providers outside of the network for an additional cost.

A POS or Point of Service plan is a type of plan in which you pay less if you use doctors, hospitals and other healthcare providers that belong to the plan’s network. POS plans may require you to get a referral from your primary care doctor in order to see a specialist.

Visit the Affordable Care Act Roadmap website from MSU Extension to find resources helpful to purchase and use health insurance. 

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