What type of insurance plan typically restricts using out-of-network providers?

The type of insurance plan that typically restricts the use of out-of-network providers is the Health Maintenance Organization (HMO). HMO plans are structured to provide care primarily through a network of designated healthcare providers and facilities. To access benefits, members usually must select a primary care physician (PCP) and receive referrals from the PCP to see specialists. This structure emphasizes the use of in-network providers to control costs and ensure coordinated care. Because HMO plans have limited coverage for out-of-network services, except in emergencies, they encourage members to utilize in-network doctors and facilities, promoting preventive care and managing healthcare costs effectively.

In contrast, Preferred Provider Organizations (PPOs) offer more flexibility by allowing members to choose any healthcare provider, including out-of-network options, although at a higher out-of-pocket cost. Exclusive Provider Organizations (EPOs) also limit coverage to in-network providers but generally do not require a referral to see specialists. Universal Health Plans are not a specific insurance type that exists in the U.S. market. Thus, HMO plans stand out for their strict adherence to using a network, which is fundamental to their design and operation.