Private browser worksheet

Plan type decision record

Use these questions to narrow what must be verified. The worksheet does not choose a plan, submit entries, or replace the exact plan documents.

Updated October 22, 2026Educational, not a quotePrimary-source links included

Plan labels

Use labels to ask better questions

Typical patterns are not guarantees
Type	Common starting pattern	Verify in the exact plan
HMO	Defined network and primary-care coordination	PCP selection, referrals, service area, emergency exceptions
PPO	Preferred network with possible outside-network benefits	Separate deductible, coinsurance, balance billing, and limits
EPO	Participating network with limited non-emergency outside care	Referral rules, network depth, travel, and emergency terms
POS	Primary-care coordination with possible outside-network pathway	Referral records, outside-network rules, and cost sharing

Write down the household priorities

Specific doctors or facilities must remain available. Routine care is used in more than one city or state. Access to specialists without a referral is important. Non-emergency out-of-network benefits are important. A lower premium matters more than broader provider choice. Regular prescriptions need a precise formulary and pharmacy check.

Entries stay in this browser page and are not submitted by the provided site code.

Read the plan-type guide

Next step

Convert each priority into evidence

Search the exact plan directory, not the carrier name alone.
Read the referral and authorization terms in the plan document.
Keep emergency rules separate from planned outside-network care.
Compare premium and cost sharing only after access requirements are checked.
Record unresolved questions and obtain a dated answer.
Repeat the checks when the plan year or household situation changes.

Use the worksheet

Complete the record with current plan documents

Use Plan type decision record with plans from the same year, address, and household facts. Leave an unknown field unresolved instead of estimating it. Save the plan ID, source URL, and date checked for every important value.

The result is a comparison aid, not a quote, eligibility decision, clinical recommendation, or prediction of claims. Confirm the final choice through the official Marketplace, employer, insurer, or licensed professional responsible for the coverage.

Verification record

Check the page against a current, plan-specific record

General information becomes actionable only after it is matched to the same household, address, enrollment route, and plan year. Keep unknown values visible instead of filling them with estimates.

Identify the exact option

Record the legal issuer or responsible program, full plan or arrangement name, plan ID when available, service area, effective dates, and official source. Similar product names can use different networks, formularies, costs, or coverage rules.

Compare a complete scenario

Use the same expected services, prescriptions, provider needs, and household facts for each option. Put premium, employer contribution or tax credit, deductible, copays, coinsurance, prescription cost, and the in-network out-of-pocket limit on the same annual basis.

Keep evidence with the decision

Save the Summary of Benefits and Coverage, policy documents, provider directory, formulary, source URL, date checked, and unresolved questions. Confirm eligibility, enrollment, provider participation, and time-sensitive rules through the responsible Marketplace, employer, insurer, provider, pharmacy, or qualified professional before acting.

Verification links

Primary sources

Sources checked September 3, 2026. Verify live plan, eligibility, and enrollment details with the responsible official source.