Short answer: An HMO keeps your monthly premium low but locks you into a set network of doctors and usually makes you get a referral before you see a specialist. A PPO costs more each month but lets you see almost any doctor — in or out of network — with no referral. For most self-employed Floridians and families who want the freedom to keep their own doctors, a PPO is the better fit, but the right choice comes down to your doctors, your budget, and how much you travel.
I'm Bernie Sobalvarro, an independent health insurance agent here in Plantation, Florida. Every week I help people untangle these four little acronyms — HMO, PPO, EPO and POS. Let me break them down the way I would at my own kitchen table.
What is an HMO?
HMO stands for Health Maintenance Organization. You pick a primary care doctor, and that doctor becomes your "quarterback." Need a dermatologist or a cardiologist? Your primary doctor has to send a referral first. Step outside the network — except for a true emergency — and the plan usually pays nothing.
The trade-off is price. HMOs almost always carry the lowest monthly premium, and the paperwork is simple because everything runs through one network. If you're healthy, watching your budget, and your doctors are already in the network, an HMO can save you real money.
What is a PPO?
PPO stands for Preferred Provider Organization, and it's the plan most of my clients end up choosing. No referrals — if you want a specialist, you just book the appointment. You can also go out of network and the plan still pays a share, just less than it would in network.
That freedom costs more up front. PPO premiums run higher than HMOs. But for a family juggling a pediatrician, an OB-GYN, and a specialist or two — or a self-employed person who travels for work — that flexibility is often worth every dollar. Take a look at our personal & family coverage page to see the kind of PPO options I can shop for you.
EPO and POS plans — the in-betweeners
Two other plan types sit between HMO and PPO:
EPO (Exclusive Provider Organization): Like a PPO, you usually don't need referrals. But like an HMO, it pays nothing out of network. Think of it as a PPO that only works inside its own lines — often at a friendlier premium.
POS (Point of Service): A hybrid. You pick a primary care doctor and get referrals like an HMO, but you can still go out of network like a PPO for a higher cost. These are less common in Florida, but worth knowing about.
A real Florida example
Last year I sat down with a married couple in Broward County. The wife is a freelance graphic designer who sees a specialist in Miami; the husband is healthy and rarely visits a doctor. The cheap HMO would have forced her to switch doctors and chase referrals every few months. We landed on a PPO instead. Yes, the premium was about $90 more a month, but it kept her specialist in network and saved her the headache — and the surprise bills — of starting over. That's the kind of math that only makes sense once you look at the actual doctors involved.
So which one is right for you?
Here's the plain-English rule I give people: choose an HMO or EPO if you want the lowest premium and you're comfortable staying inside one network. Choose a PPO if keeping your own doctors and skipping referrals matters more than saving on the monthly bill. And always — always — check that your actual doctors and prescriptions are covered before you sign anything. Premium is only one piece; your deductible and which doctors you can see matter just as much. If you also want to understand the dollars behind these plans, my guide on how much individual health insurance costs in Florida walks through real 2026 numbers.
Running a company and choosing a plan type for your team? The same rules apply, just at a bigger scale — see our small business health insurance page.
Let's find your plan
You don't have to guess. As an independent agent licensed in 31 states, I shop HMO, PPO, EPO and POS plans across multiple carriers and tell you — honestly — which one fits your doctors and your budget. Book a free quote here or call me directly at (305) 900-5903. It costs you nothing to find out your options.
