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Plan Types

There are different types of health insurance plans offered through MNsure designed to meet different needs. Depending what is offered in your area, you may find plans of all or any of the types listed below in each metal level.

Learning the difference between plan types offered on the various provider networks can help you compare plans to find the right coverage for you and your family. Plan features may change from year to year, like network, deductibles and co-pays. Be sure to review the summary of benefits and coverage (SBC) for your plan if you are a renewing customer. SBCs for all plans offered on MNsure can be found using our shop and compare tool. If you have specific questions about your plan, please contact your insurance company.

  • Exclusive Provider Organization (EPO): A managed care plan where services are covered only if you use doctors, specialists or hospitals in the plan's network (except in an emergency).

  • Health Maintenance Organization (HMO): A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. 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.

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

  • Preferred Provider Organization (PPO): A type of health plan which includes a network of health care providers with which a health insurer has negotiated contracts for its insured population to receive health services at discounted costs. Health care decisions generally remain with the patient as he she selects providers and determines his or her own need for services. Patients have financial incentives to select providers within the PPO network.

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