What is the difference between an HMO, PPO and POS?

POS stands for Point of Service. As with the HMO, a POS requires you to get referrals from your primary care physician (PCP) before seeing a specialist. However, this plan covers out-of-network doctors, though you will pay more than for in-network doctors. ERS offers this plan, HealthSelect of Texas.

HMO stands for health maintenance organization. HMOs have their own network of doctors, hospitals and other healthcare providers who have agreed to accept payment at a certain level for any services they provide. There are no out-of-network options. ERS does not offer this plan to state agencies.

PPO stands for Preferred Provider (PPO), has higher premiums than an HMO or POS. But this plan allows you to see a specialist and out-of-network doctors without a referral. ERS does not offer this plan to state agencies.

Answer provided by Erica Morales, Director of UHD Benefits & Compensation

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