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There are different types of Marketplace health insurance plans designed to meet different needs. Some health insurance network types restrict your provider choices or encourage you to get care from the plan’s network of doctors, hospitals, pharmacies, and other medical service providers. Others pay a greater share of costs for providers outside the plan’s network.

So what’s the best health plan network? That depends on your needs.

Today we’ll look at the different health insurance network types, types of Marketplace plans, and how to choose a health insurance network.

Types of Marketplace Health Insurance Plans

Depending on how many health insurance plans are offered in your area, you may find plans of all or any of these types at each metal level – Bronze, Silver, Gold, and Platinum. Within those, there are 4 major health insurance network types:

Below are some examples of types of Marketplace plans to help you pick the best health plan network for your needs.

To see the health plan networks available in Kansas, download the 2022 Kansas Insurance Plans Brief (PDF).

Exclusive Provider Organization (EPO) Health Plans

An EPO health plan is a managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan’s EPO network (except in an emergency).

What are the Pros of EPOs?

What are the Cons of EPOs?

Health Maintenance Organization (HMO) Health Plans

An HMO health plan is a type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO network. It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.

HMO Pros

HMO Cons

Point of Service (POS) Health Plans

A POS health plan is a type of plan where you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s POS network. POS plans require you to get a referral from your primary care doctor in order to see a specialist.

POS Pros

POS Cons

Preferred Provider Organization (PPO) Health Plans

A PPO health plan is a type of health plan where you pay less if you use providers in the plan’s PPO network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost.

PPO Pros

PPO Cons

A young woman contemplates different health insurance types. It includes the Cover Kansas logo and the text 'We can help!'

Help Choosing a Health Insurance Plan

If you are unsure about which type of health insurance plans are best for your needs, or you need help picking the best health plan network for your needs, Cover Kansas can help! We offer FREE services to help all Kansas residents with choosing health insurance plans in the marketplace.

Cover Kansas Navigators are trained, unbiased individuals that can help you compare health insurance plans, assist you with the online application process, and provide answers to your Marketplace questions year-round.

We understand that getting coverage through the federal Health Insurance Marketplace can be a complicated process. That’s why we simplified it! Check out our website to find answers to any questions you might have about enrolling and get free assistance from a certified Navigator.

Health Care Coverage Guide

Want more information about how to get affordable health insurance in Kansas? Check out our comprehensive Health Care Coverage Guide. It covers: