Question

What are the principle difference among HMO, POK, and POS plans?

Answer 1

	HMO	POK	POS
	Health Maintenance organisation		Point of Service
difference	a wide range of healthcare services through a network of providers who agree to supply services to members. needs a primary care physician and needs a referral for whatever investigation patient want to take or to consult a specialist and specialist should be within the network. patient has to pay the full cost if consultation is outside the network		freedom to see any physician or other healthcare professionals from a network of providers or seek care outside of the network. can consult a specialist outside the network with a referral letter from the primary care physician . access to out-of-network providers at an increased cost.

PPO (preferred provider organisation)

• no need to select primary care physician
• no need for referrals
• if a patient wants to see a provider in a preferred network, the patient is only responsible to pay a portion of the bill.

EPO (Exclusive provider network)

• no need of referral to get care from a specialist
• if patient want to seek care from outside network, need to pay the full cost.