Decoding Health Insurance: Understanding PPO, HMO, POS and EPO with Parita Patel
Nov 01, 2023
Parita Patel with Mike Sedita
Ever felt like you needed a translator just to understand your health insurance plan? Fear not! In our latest episode, we're joined by the health insurance guru, Parita Patel from Parita Health, who is going to decode the jargon for us. Parita breaks down the alphabet soup of PPO, HMO, POS, and EPO, dissecting how each plan impacts your choices of doctors and medical treatments.
Parita delivers a master class on the complex world of health insurance, giving you the tools you need to navigate your healthcare journey. She dives into the perks and pitfalls of each plan type, from the broad reach of Preferred Provider Organization (PPO) plans to the more cost-effective, but restrictive, Health Maintenance Organization (HMO) offerings. We also delve into the specifics of Point of Service (POS) and Exclusive Provider Organization (EPO) plans. Remember, understanding your health insurance is not a luxury; it’s a necessity. Tune in for a deep dive into health insurance and get empowered to take control of your health decisions.
Ever felt like you needed a translator just to understand your health insurance plan? Fear not! In our latest episode, we're joined by the health insurance guru, Parita Patel from Parita Health, who is going to decode the jargon for us. Parita breaks down the alphabet soup of PPO, HMO, POS, and EPO, dissecting how each plan impacts your choices of doctors and medical treatments.
Parita delivers a master class on the complex world of health insurance, giving you the tools you need to navigate your healthcare journey. She dives into the perks and pitfalls of each plan type, from the broad reach of Preferred Provider Organization (PPO) plans to the more cost-effective, but restrictive, Health Maintenance Organization (HMO) offerings. We also delve into the specifics of Point of Service (POS) and Exclusive Provider Organization (EPO) plans. Remember, understanding your health insurance is not a luxury; it’s a necessity. Tune in for a deep dive into health insurance and get empowered to take control of your health decisions.
Speaker 1:
Hello and welcome to the Good Neighbor podcast. I'm your host, Mike Sedita. Our podcast today is sponsored by Perida Health peridahealthcom. My co-host is an expert in health insurance in the Tampa market, Perida Patel. Perida, how are you doing today?
Speaker 2:
Hi, mike, doing great. Thank you.
Speaker 1:
Thank you so much for being on. We have a very important podcast today because we want to describe what the different types of health insurance plans there are. So can you explain to people what is the difference between a PPO and AGO, hmo, a POS and an EPO?
Speaker 2:
Absolutely, mike. These are important terms to know because they describe what kind of network your insurance is in. So it basically represents how many doctors are available for the insurance plan that you have, because a lot of times if you go to use your benefits and you are out of network, that's in relation to those four terms that you mentioned. So the first one I'm going to go over is PPO. That stands for preferred provider organization. Obviously, the word preferred is preferred, right. So usually this means you have a much wider network. You do not have to ask permission to see a specialist and it's going to allow you to access more doctors than not. So a lot of times PPO networks could be the entire state, and then there are some plans that even allow you to go nationwide if it's a nationwide PPO plan. So if you have to choose between the four, that is going to be the best one, but a lot of times that can also mean it's more expensive, unless you look at the right places, because there are private plans that are PPO that are more affordable. I digress Now.
Speaker 2:
You have HMO plans, health maintenance organization. Now that is basically going to be an HMO right. You've got maybe two or three doctors to choose from, of every kind. You've got two primary cares. You've got two gynecologists, dermatologists so you've got a couple of options. You do have to get permission from your primary care doctor to see a specialist. So if I'm not feeling 100%, first I have to go talk to my primary care doctor and let him know I'm not feeling well, and then he's going to say, okay, that sucks, now let's go see another doctor, instead of you going straight to the doctor that is actually going to help you.
Speaker 1:
So a little bit more frustrating. Now a POS. I think that's a good idea.
Speaker 2:
I'm going to say. I think we all know what that stands for, but it does also stand for point of service, Correct.
Speaker 1:
That's what I was thinking. That's exactly what I was thinking.
Speaker 2:
Exactly Right. Similar type of situation where you have a limited network and you basically just show up and you try to pay for the service right at that moment, right. Last but not least is EPO, which stands for Exclusive Provider Organizations. The best way for me to describe this is exclusively. Nobody accepts that insurance.
Speaker 1:
No, it's on the list, but it's not really on the list.
Speaker 2:
Right, you've got maybe one doctor of every kind to choose from, and because there are so few options, the doctors are going to be booked out for months. So if you even need to see a specialist, you're going to have to wait three or four months before one's available that accepts your insurance if it's an EPO plan. So hopefully that helps people understand how networks work. It's a very important deciding factor for you when you're picking your insurance plan.
Speaker 1:
The best part about this is we covered a lot of information there. There's a lot of acronyms. Some are more easy to remember than others, but the reality is you don't need to remember them If you are thinking about getting health insurance. All you need to do is go to paridahealthcom, contact Parida and her team. They will go over all of the different types of options you have and figure out. Do you want to pay more and wait less, and pick your doctor, or pay a little bit less, wait a long time and only have a couple of options? She can help you navigate that. All you have to do is go to paridahealthcom, Parida thank you for educating us today.
