DIVERSIFIED HEALTH CARE SYSTEMS, INC.
Accepted Insurance for NPI 1982601621
Home Health in Houston, TX

Q: What managed care network types are accepted by this provider?

DIVERSIFIED HEALTH CARE SYSTEMS, INC. is enrolled across the following managed care network types: EPO, HMO, POS. HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.EPO (Exclusive Provider Organization): Restricts coverage strictly to network providers except for emergency situations, but generally allows seeking treatment from network specialists without an official referral.POS (Point of Service): Bridges elements of HMO and PPO rules. It generally mandates an in-network primary care physician referral for specialized services but retains partial out-of-network lookup allowances at heightened cost tiers.

NPI Status: Active since July 07, 2005

Contact Information

7322 SOUTHWEST FWY STE 775
HOUSTON, TX
ZIP 77074
Phone: (713) 526-3482
Fax: (713) 526-2058

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Accepted Health Plans and Insurance Coverage

This registry outlines the health plan networks and insurance coverage profiles associated with DIVERSIFIED HEALTH CARE SYSTEMS, INC., a practicing home health professional in Houston, TX. Compiled from official data resources, this interface is designed to help you determine if your policy is accepted at this practice location. Currently, the provider is listed across 595 individual coverage options managed by medical networks, including networks like Blue Cross and Blue Shield of Texas, Oscar Insurance Company, and WellPoint. Please use the filtering dashboard below to search for your specific plan by name, narrow results by a single carrier corporate network, or toggle between plan types (HMO, PPO, EPO) to check your status before coordinating an upcoming clinic visit.

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Fitler by Network Type

Blue Cross and Blue Shield of Texas

Blue Advantage Bronze HMO? 204

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046055433602TX046070533602TX046070633602TX046070733602TX046070833602TX046070933602TX046071033602TX046071133602TX046071233602TX046071333602TX046071433602TX046071533602TX046071633602TX046071733602TX046071833602TX046071933602TX046072133602TX046072233602TX046072333602TX046072433602TX046072533602TX046072633602TX046072733602TX046072833602TX046086933602TX046107333602TX0461074

Blue Advantage Bronze HMO? 301

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046078233602TX046078333602TX046078733602TX046079233602TX046079333602TX046079433602TX046079533602TX046079733602TX046079933602TX046080133602TX046080233602TX046080333602TX046080433602TX0460806

Blue Advantage Bronze HMO? Standard

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046103333602TX046103433602TX046103533602TX046103633602TX046103733602TX046103833602TX046103933602TX046104033602TX046104133602TX046104233602TX046104333602TX046104433602TX046104533602TX046104633602TX046104733602TX046104833602TX046104933602TX046105033602TX046105133602TX046105233602TX046105333602TX046105433602TX046105533602TX046105633602TX046105733602TX046105833602TX0461079

Blue Advantage Gold HMO? 206

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046054833602TX046055533602TX046055633602TX046055733602TX046055833602TX046055933602TX046056033602TX046056133602TX046056233602TX046056333602TX046056433602TX046056533602TX046056633602TX046056733602TX046056833602TX046056933602TX046057133602TX046057233602TX046057333602TX046057433602TX046057533602TX046057633602TX046057733602TX046057833602TX046086333602TX046106133602TX0461062

Blue Advantage Gold HMO? 603

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046080933602TX046081433602TX046081933602TX046082033602TX046082133602TX046082233602TX046082433602TX046082633602TX046082833602TX046082933602TX046083033602TX046083133602TX046083333602TX0460860

Blue Advantage Gold HMO? Standard

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046092533602TX046092833602TX046092933602TX046093033602TX046093133602TX046093233602TX046093333602TX046093433602TX046093533602TX046093633602TX046093733602TX046093833602TX046093933602TX046094033602TX046094133602TX046094233602TX046094333602TX046094433602TX046094533602TX046094633602TX046094733602TX046094833602TX046094933602TX046095033602TX046095133602TX046095233602TX0460953

Blue Advantage Plus Bronze? 303

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087000233602TX087003833602TX087003933602TX087004033602TX087004133602TX087004233602TX087004333602TX087004433602TX087004533602TX087004633602TX087004733602TX087004833602TX087004933602TX087005033602TX087005133602TX087005233602TX087005333602TX087005433602TX087005533602TX087005633602TX087005733602TX087005833602TX087005933602TX087006033602TX087006133602TX087006233602TX0870063

Blue Advantage Plus Bronze? 305

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087000333602TX087006433602TX087006533602TX087006633602TX087006733602TX087006833602TX087006933602TX087007033602TX087007133602TX087007233602TX087007333602TX087007433602TX087007533602TX087007633602TX087007733602TX087007833602TX087007933602TX087008033602TX087008133602TX087008233602TX087008333602TX087008433602TX087008533602TX087008633602TX087008733602TX087008833602TX0870089

Blue Advantage Plus Bronze? Standard

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087000433602TX087009033602TX087009133602TX087009233602TX087009333602TX087009433602TX087009533602TX087009633602TX087009733602TX087009833602TX087009933602TX087010033602TX087010133602TX087010233602TX087010333602TX087010433602TX087010533602TX087010633602TX087010733602TX087010833602TX087010933602TX087011033602TX087011133602TX087011233602TX087011333602TX087011433602TX0870115

Blue Advantage Plus Gold? 203

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087000533602TX087011633602TX087011733602TX087011833602TX087011933602TX087012033602TX087012133602TX087012233602TX087012333602TX087012433602TX087012533602TX087012633602TX087012733602TX087012833602TX087012933602TX087013033602TX087013133602TX087013233602TX087013333602TX087013433602TX087013533602TX087013633602TX087013733602TX087013833602TX087013933602TX087014033602TX0870141

Blue Advantage Plus Gold? 803

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087001133602TX087027233602TX087027333602TX087027433602TX087027533602TX087027633602TX087027733602TX087027833602TX087027933602TX087028033602TX087028133602TX087028233602TX087028333602TX087028433602TX087028533602TX087028633602TX087028733602TX087028833602TX087028933602TX087029033602TX087029133602TX087029233602TX087029333602TX087029433602TX087029533602TX087029633602TX0870297

Blue Advantage Plus Gold? Standard

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087000633602TX087014233602TX087014333602TX087014433602TX087014533602TX087014633602TX087014733602TX087014833602TX087014933602TX087015033602TX087015133602TX087015233602TX087015333602TX087015433602TX087015533602TX087015633602TX087015733602TX087015833602TX087015933602TX087016033602TX087016133602TX087016233602TX087016333602TX087016433602TX087016533602TX087016633602TX0870167

Blue Advantage Plus Silver? 202

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087000733602TX087016833602TX087016933602TX087017033602TX087017133602TX087017233602TX087017333602TX087017433602TX087017533602TX087017633602TX087017733602TX087017833602TX087017933602TX087018033602TX087018133602TX087018233602TX087018333602TX087018433602TX087018533602TX087018633602TX087018733602TX087018833602TX087018933602TX087019033602TX087019133602TX087019233602TX0870193

Blue Advantage Plus Silver? 605

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087000933602TX087022033602TX087022133602TX087022233602TX087022333602TX087022433602TX087022533602TX087022633602TX087022733602TX087022833602TX087022933602TX087023033602TX087023133602TX087023233602TX087023333602TX087023433602TX087023533602TX087023633602TX087023733602TX087023833602TX087023933602TX087024033602TX087024133602TX087024233602TX087024333602TX087024433602TX0870245

Blue Advantage Plus Silver? Standard

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087001033602TX087024633602TX087024733602TX087024833602TX087024933602TX087025033602TX087025133602TX087025233602TX087025333602TX087025433602TX087025533602TX087025633602TX087025733602TX087025833602TX087025933602TX087026033602TX087026133602TX087026233602TX087026333602TX087026433602TX087026533602TX087026633602TX087026733602TX087026833602TX087026933602TX087027033602TX0870271

Blue Advantage Security HMO? 200

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046055233602TX046065533602TX046065633602TX046065733602TX046065833602TX046065933602TX046066033602TX046066133602TX046066233602TX046066333602TX046066433602TX046066533602TX046066633602TX046066733602TX046066833602TX046066933602TX046067133602TX046067233602TX046067333602TX046067433602TX046067533602TX046067633602TX046067733602TX046067833602TX046087233602TX046107733602TX0461078

Blue Advantage Silver HMO? 205

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046055333602TX046068033602TX046068133602TX046068233602TX046068333602TX046068433602TX046068533602TX046068633602TX046068733602TX046068833602TX046068933602TX046069033602TX046069133602TX046069233602TX046069333602TX046069433602TX046069633602TX046069733602TX046069833602TX046069933602TX046070033602TX046070133602TX046070233602TX046070333602TX046086733602TX046106933602TX0461070

Blue Advantage Silver HMO? 801

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046108333602TX046109033602TX046109433602TX046109933602TX046110033602TX046110133602TX046110233602TX046110433602TX046110533602TX046110733602TX046110833602TX046110933602TX046111033602TX0461112

Blue Advantage Silver HMO? Standard

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046092633602TX046095433602TX046095533602TX046095633602TX046095733602TX046095833602TX046095933602TX046096033602TX046096133602TX046096233602TX046096333602TX046096433602TX046096533602TX046096633602TX046096733602TX046096833602TX046096933602TX046097033602TX046097133602TX046097233602TX046097333602TX046097433602TX046097533602TX046097633602TX046097733602TX046097833602TX0460979

Oscar Insurance Company

Bronze Classic 4700

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX0100024

Bronze Classic Standard

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX0100050

Bronze Elite + PCP Saver Plus

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX0100005

Bronze Simple Breathe Easy with Enhanced COPD Benefits

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX0100064

Bronze Simple Chronic Care CKM

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX0100059

Bronze Simple Diabetes

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX0100068

Gold Classic

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX0100055

Gold Classic Guided Care

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX051002020069TX051002220069TX051002420069TX051005520069TX051006320069TX051007120069TX051007920069TX0510127

Gold Classic Standard

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX0100053

Gold Classic Standard Guided Care

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX051003220069TX051003420069TX051003620069TX051005720069TX051006520069TX051007320069TX051008120069TX0510128

Gold Elite

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX0100056

Gold Simple Diabetes Guided Care

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX051003720069TX051003820069TX051003920069TX051004220069TX051004320069TX051004420069TX051004520069TX0510129

Gold Simple Guided Care

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX051002120069TX051002320069TX051002520069TX051005620069TX051006420069TX051007220069TX051008020069TX0510130

Silver Classic

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX0100006

Silver Classic Standard

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX0100052

Silver Classic Standard Guided Care

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX051003120069TX051003320069TX051003520069TX051005420069TX051006220069TX051007020069TX051007820069TX0510120

Silver Simple Breathe Easy with Enhanced COPD Benefits Guided Care

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX051000120069TX051000220069TX051000320069TX051000420069TX051000520069TX051000620069TX051000720069TX0510121

Silver Simple Chronic Care CKM Guided Care

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX051001220069TX051001620069TX051004020069TX051005220069TX051006020069TX051006820069TX051007620069TX0510122

Silver Simple Diabetes Guided Care

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX051001320069TX051001720069TX051004120069TX051005320069TX051006120069TX051006920069TX051007720069TX0510123

Silver Simple Guided Care

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX051001020069TX051001420069TX051001820069TX051005020069TX051005820069TX051006620069TX051007420069TX0510124

Silver Simple PCP Saver

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX0100025

Silver Simple PCP Saver Guided Care

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX051001120069TX051001520069TX051001920069TX051005120069TX051005920069TX051006720069TX051007520069TX0510125

Silver Simple Women's Health with Menopause Benefits Guided Care

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

20069TX051000820069TX051000920069TX051002620069TX051002720069TX051002820069TX051002920069TX051003020069TX0510126

WellPoint

Wellpoint Essential Bronze 4000 HSA (+ Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040002

Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040004

Wellpoint Essential Bronze 6000 Adult Dental/Vision ($0 Virtual PCP+$0 Select Drugs)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040003

Wellpoint Essential Bronze 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040005

Wellpoint Essential Bronze POS 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030003

Wellpoint Essential Bronze POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030002

Wellpoint Essential Bronze POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030004

Wellpoint Essential Catastrophic (+ Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040006

Wellpoint Essential Gold 1500 ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040007

Wellpoint Essential Gold 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040008

Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040009

Wellpoint Essential Gold POS 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030005

Wellpoint Essential Gold POS 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030006

Wellpoint Essential Gold POS 700 ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030007

Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040011

Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040012

Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040010

Wellpoint Essential Silver 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040013

Wellpoint Essential Silver POS 2500 ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030008

Wellpoint Essential Silver POS 4000 ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030009

Wellpoint Essential Silver POS 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030001

No coverage plans found coordinating with your query criteria.

Coverage Information & FAQs

What insurance does DIVERSIFIED HEALTH CARE SYSTEMS, INC. accept?

This provider accepts health insurance plans managed by the following insurance companies: Blue Cross and Blue Shield of Texas, Oscar Insurance Company, WellPoint. You can filter specific policies or search for unique plans using the open dashboard controls located above.

Is this provider enrolled to accept Medicare?

No, current public enrollment indicators show that this provider does not accept standard Medicare program assignments.

What managed care network types are accepted by this provider?

DIVERSIFIED HEALTH CARE SYSTEMS, INC. is enrolled across the following managed care network types: EPO, HMO, POS.

HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.
EPO (Exclusive Provider Organization): Restricts coverage strictly to network providers except for emergency situations, but generally allows seeking treatment from network specialists without an official referral.
POS (Point of Service): Bridges elements of HMO and PPO rules. It generally mandates an in-network primary care physician referral for specialized services but retains partial out-of-network lookup allowances at heightened cost tiers.