Now you can also have a 4 wire 220 V circuit.
Now this plug in does not look like the picture above because this outlet has a forth connector.
This type of circuit has a 4th wire which is the neutral wire, plus the two hot wires and the ground.
This 4 wire 220V circuit is typical on you stove outlet amongst other things.
220V 4 wire outlet
Here is a video showing you all about this type of 220V circuit.