After you submit your application Where can I find the plan type when I’m shopping in the Marketplace? When you apply for coverage through the Marketplace, you can compare plans and prices, and When comparing plans on HealthCare.gov, the plan find out about any savings that may be available to type is listed immediately below its name. Look for help lower your monthly premiums. You can search the initials PPO, POS, HMO, or EPO. The type of plan for specific plans, providers, facilities, or by Plan ID. is also listed on each plan’s “Summary of Benefits Each plan description includes a link to its provider and Coverage.” If you’re not sure what the plan type directory. If you want coverage for dependents, is or you want to know more about the coverage it search for their doctors and facilities too. offers, you can call the health insurance company directly. You can also call the Marketplace Call Center How do different types of plans use at 1-800-318-2596 (TTY: 1-855-889-4325). To find in- provider networks? person assistance in your area, visit LocalHelp.HealthCare.gov. Depending on the type of plan you buy, your plan may cover your care only when you see a network provider. Why do some plans cover benefits and You may have to pay more, and/or get a referral if you services from network providers, but choose to get care from a provider who isn’t in your not out-of-network providers? plan’s network. Types of plans include: Network providers have agreed to offer benefits or Preferred Provider Organizations (PPOs): You pay services to the plan’s members at prices that the n less if you use providers in the plan’s network. For an provider and the plan agreed on. This generally additional cost, you can use doctors, hospitals, and means that they provide a covered benefit at a lower providers outside of the network without a referral. cost to the plan and the plan’s members than to someone without insurance or someone in a plan Point-of-Service (POS) Plans: You pay less if you use where the provider is out-of-network. n doctors, hospitals, and other health care providers that belong to the plan’s network. You’re required to All Marketplace plans must have provider networks get referrals from your primary care doctor to see with enough types of providers to ensure that specialists. their plan members can get plan services without unreasonable delay. Depending on your plan, if you Health Maintenance Organizations (HMOs): use an out-of-network provider, you may have to n You’re usually limited to care from doctors who work pay the full cost of the benefits and services you get for or contract with the HMO and aren’t covered for from that provider, except for emergency services. out-of-network care (except in an emergency). You may be required to live or work in the HMO’s service Insurance plans can’t make you pay more in area to be eligible for coverage. copayments or coinsurance if you get emergency care from an out-of-network hospital. They also can’t Exclusive Provider Organizations (EPOs): You’re make you get prior approval before getting emergency n only covered if you use doctors, specialists, or services from a provider or hospital outside your hospitals in the plan’s network (except in an plan’s network. However, you may have to pay some emergency). out-of-pocket costs, like a deductible, at the in-network rates. Plans aren’t allowed to charge you out-of- network cost-sharing (like out-of-network coinsurance or copayments) for emergency and certain non- emergency services.