Medicare Advantage HMO enrollees did get more bypass grafts. (AP Photo/Petros Giannakouris)
(The Washington Post) – What’s in a name? When it comes to health plans sold on the individual market these days, it’s often less than people think. The lines that distinguish HMOs, PPOs, EPOs and POS plans from one another have blurred, making it hard to know what you’re buying by name alone — assuming you’re one of the few people who know what an EPO is in the first place.
“Now, there’s a lot of gray out there,” says Sabrina Corlette, project director at Georgetown University’s Center on Health Insurance Reforms.
Ideally, a plan’s type provides a shorthand way to determine what access members have to providers outside its network, including such things as cost-sharing for treatment. But because there are no industry-wide definitions of plan types and because state standards vary, individual insurers often have leeway to market similar plans under different names. In general: