What the heck is an EPO health insurance plan?

January 29, 2016

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Lead Copywriter



In technical speak:

An Exclusive Provider Organization plan (EPO) is similar to an HMO plan in that it has a limited doctor network and no out-of-network coverage, but it is similar to a PPO plan in that you don’t have to designate a primary care physician upon applying, and you don’t need a referral to see a specialist.

In normal speak:
The sweet thing about EPO plans is that you don’t need to see your doc to get a referral to see a specialist. That means you pay for only ONE doc appointment. You also don’t have to designate your primary care physician when you apply, which is nice since sometimes we don’t have a primary care physician. The only bummer thing is that EPO plans don’t offer a huge coverage network. That’s why it’s important to see if your doc takes your EPO plan before you apply. Also, make sure you don’t get medical services outside of your coverage network, otherwise you’ll be paying an arm and a leg.

Learn more about PPO, POS or HMO plans.

If you’re interested in an EPO plan or would like to learn about the other health insurance plans available, we can help.