KEY WORDS AND PHRASES Getting the Getting the Health Care You NeedHealth Care You Need Health Maintenance Organizations (HMOs) and Exclusive Provider Organizations (EPOs) Plans that usually cover only care that is provided within their network. They also often require you to pick a “primary care doctor” to go to for your regular visits (like a family physician, an internist, or a pediatrician) who has to give you permission, or a “referral,” to see a specialist. Preauthorization A requirement that certain services, treatments, medications, and equipment be approved in advance by the insurance company, except in emergencies. While getting preauthorization doesn’t guarantee that the service will be covered, not getting it when you need to will likely cause you to pay more than you could have if you had gotten preauthorization. TIP: To get the most out of your insurance, know your plan’s rules. To save the most money, try to stay in its preferred provider network (if it has one) and get the proper referrals and preauthorizations if you need them.