An Exclusive Provider Organization (EPO) 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. Here are some key features of an EPO insurance plan:

• In-network coverage only: EPO plans contract with doctors and hospitals to provide care to the health plan’s members. These providers are called “network providers” or “in-network providers,” and they include physicians, specialists, and facilities, like labs, hospitals, and urgent care centers. A provider that does not have a contract with the health plan is called an “out-of-network provider” .

• No referrals required: EPO members do not need to select a primary care physician (PCP) or get referrals to see specialists.

• Out-of-network coverage for emergencies: EPO plans do not cover out-of-network care unless it’s an emergency.

• Lower monthly premiums: EPOs are usually more pocket-friendly than PPO plans.

• Deductibles: EPO insurance typically comes with a deductible, which is the amount that you pay to share the cost of your healthcare. Once the deductible has been met, the insurance starts to share the costs.

• Health Savings Account options: Some EPO plans are available with Health Savings Accounts (HSA), which can help members save money. The money members put in their HSAs is tax-deductible, and withdrawals are tax-free when used to pay for qualified medical expenses. The HSA account balance rolls over from year to year, and the money in the account belongs to the member.

EPO plans are a type of major medical insurance that provides minimum essential coverage for healthcare services. They offer a local network of doctors and hospitals for members to choose from.