Find the tradeoff, not a ranking
Compare coverage structures before comparing individual quotes. Availability and terms vary by plan and location.
A network type describes how access works. A metal category describes cost sharing. A source of coverage describes where you enroll. These are different dimensions: a Marketplace plan can be an HMO or a PPO. None of these labels guarantees that a particular doctor, drug or service is covered.
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| Structure or route | What to compare | Useful question | Watch for |
|---|---|---|---|
| HMO | Network and service area | Are my doctors in this exact network? | Out-of-network coverage is generally limited except emergencies. |
| PPO | In-network versus out-of-network benefits | What extra cost applies outside the network? | A broader access option can still leave substantial out-of-network charges. |
| EPO | Network-only covered care | Is the facility, not just the doctor, in network? | Generally network-only except emergencies. |
| POS | Primary care and referrals | Do I need a referral for this specialist? | Referrals and network rules matter together. |
| Marketplace coverage | Benefits, net premium and current eligibility | What does my completed application show? | A preview price is not a final eligibility determination. |
| Employer coverage | Employee premium and plan documents | What does my employer contribute? | Family coverage and plan-year timing may differ. |
| Continuation coverage | Existing coverage and full continuation cost | What deadline and effective date apply? | Request the formal election notice and check alternatives. |
| Supplemental fixed-benefit coverage | Specified cash benefits and exclusions | Does it replace comprehensive coverage? | Do not assume a limited-benefit policy pays all medical bills. |
Verify the details
Read the current Summary of Benefits and Coverage and the policy documents. This table compares structures, not companies, quality ratings or actual prices. HealthCare.gov plan types describes HMO, PPO, EPO and POS arrangements. The Department of Labor provides employer-plan and continuation coverage information. Ask the applicable official agency or a licensed professional about your circumstances.