Which type of health insurance plan requires policyholders to use in-network services?

A Health Maintenance Organization (HMO) type of health insurance plan is designed to provide services primarily through a network of providers that have agreed to provide care for the HMO's members. Policyholders are typically required to select a primary care physician (PCP) who coordinates their healthcare and provides referrals to specialists within the network. This structure promotes preventive care and helps manage costs, fostering an environment where members are encouraged to use in-network services to receive the full benefits of their plan.

While other plans like Preferred Provider Organizations (PPOs) and Exclusive Provider Organizations (EPOs) also offer network-based services, they provide different levels of flexibility. PPO plans allow more freedom of choice for policyholders to seek care outside the network, albeit usually at a higher cost. EPOs generally do not require referrals to see specialists within their network but still emphasize the use of in-network providers. POS plans combine features of HMOs and PPOs, allowing members to choose between in-network and out-of-network services but also typically require a focus on in-network providers for maximum coverage.