what is an epo

what is an epo

1 year ago 35
Nature

An EPO, or Exclusive Provider Organization, is a type of health plan that falls somewhere between a Health Maintenance Organization (HMO) and a Preferred Provider Organization (PPO) in terms of cost and flexibility. With an EPO, members have only in-network coverage (except for emergencies), but they do not need to select a primary care physician (PCP) or get referrals to see specialists. EPO plans contract with doctors and hospitals to provide care to the health plan’s members, and these providers are called “network providers” or “in-network providers”. EPO members are only covered for services received from in-network providers, and they are covered for emergency care no matter where they are — in or out of network. EPO insurance typically offers lower rates than other kinds of insurance plans, but it usually comes with a deductible.

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