Plan type controls which doctors you can see and how much you pay to see them. In many areas, most marketplace plans are HMOs or EPOs, so it's worth understanding the trade-offs.
HMO
You use doctors and hospitals in the plan's network, usually choose a primary care doctor, and often need a referral to see a specialist. Out-of-network care generally isn't covered except in emergencies. Premiums tend to be lower.
Licensed agents compare plans from several carriers, check your doctors and estimate your subsidy. Free to you.
Call 866-645-8540EPO
Like an HMO, care must be in network except for emergencies, but you usually don't need referrals to see specialists.
PPO
You can see out-of-network providers, though you'll pay more. No referrals needed. Premiums are usually higher, and PPOs aren't available in every county.
POS
A hybrid: you pick a primary care doctor and get referrals like an HMO, but have some out-of-network coverage.
How to choose
Start with your doctors. If the providers you care about are in an HMO or EPO's network, that plan may give you the best price. If you travel often or see specialists across health systems, a PPO may be worth the cost. An agent can check each plan's network for you.
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