Health Insurance Glossary
HMO (HEALTH MANAGEMENT ORGANIZATION)
Cheapest plan option. Participants have to select a Primary Care Physician (PCP) that they have to obtain a referral from before they can visit a specialist. Coverage is limited only to providers that are In-Network for that plan. HMO networks are not as broad as the more expensive plans, usually restricted to a local area or state only.
epo (exclusive provider organization)
Slightly more expensive than HMO. Do not require a specialist referral from a PCP, but the providers still have to be In-Network (broader network than HMO)
pos (point of service)
Also require a referral to see a specialist, but they have coverage for providers that are Out-of-Network (most cover at a lower rate than In-Network).
ppo (preferred provider organization)
Usually the most expensive plans. Do not require specialist referrals, and they have Out-of-Network coverage. Normally accepted by a wider network of physicians and facilities, so there are more options.
deductible
The amount that the participants need to pay before the insurance plan starts covering claims. There are low-deductible plans and High Deductible.
The higher the deductible, the cheaper the plan normally is.
coinsurance
Portion of the cost that the participants are responsible for - after the deductible is met. Some plans cover at 60%, which are cheaper, and others at 100% which are more expensive.
Hdhp (high deductible health plan)
Health insurance plan that has a deductible over $1,700 in 2026. HDHPs can be paired with a Health Savings Account (HSA) that lets both employers and participants put aside money on a tax-free basis to pay for qualifying expenses. The funds can be rolled over if not spent during the plan year.
copayment
A fixed amount that the participant has to pay every time they incur a covered service. There can be copays for a PCP visit, specialist, urgent care, hospitalization, imaging, Emergency Room, etc.