What Is the Difference Between Epo and Ppo?

What Is the Difference Between Epo and Ppo?
An EPO (or “exclusive provider organization”) is a bit like a hybrid of an HMO and a PPO. EPOs generally offer a little more flexibility than an HMO and are generally a bit less pricey than a PPO. But like an HMO, you are responsible for paying out-of-pocket if you seek care from a doctor outside your plan's network.

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Keeping this in consideration, is it better to have an EPO or PPO?

EPO health plans are often more affordable than PPO plans if you choose a doctor or specialist in your local network. However, while EPO plans are less expensive then both HMO and PPO plans, the cost-savings do not come without drawbacks.

Furthermore, what is the difference between an HMO and PPO? An HMO is a Health Maintenance Organization, while PPO stands for Preferred Provider Organization. The differences, besides acronyms, are distinct. But the major differences between the two plans is the cost, size of the plan network, your ability to see specialists, and coverage for out-of-network services.

Then, what is an EPO health insurance plan?

EPO Insurance Plans EPO stands for "Exclusive Provider Organization" plan. As a member of an EPO, you can use the doctors and hospitals within the EPO network, but cannot go outside the network for care. There are no out-of-network benefits.

Do you need referral for EPO?

Exclusive provider organizations (EPOs) are a lot like HMOs: They generally don't cover care outside the plan's provider network. Members, however, may not need a referral to see a specialist. Point of Service (POS) plans vary, but they're often a sort of hybrid HMO/PPO.

Related Question Answers

How do EPO plans work?

A type of managed care health insurance, EPO stands for exclusive provider organization. An EPO health plan's rules center around two basic cost-containment techniques: For services to be covered, you have to receive medical services from doctors and hospitals with whom the EPO has negotiated discounts.

Are PPO plans good?

PPOs Usually Win on Choice and Flexibility
If flexibility and choice are important to you, a PPO plan could be the better choice. Unlike most HMO health plans, you won't likely need to select a primary care physician, and you won't usually need a referral from that physician to see a specialist.
James H. Sterling
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James H. Sterling

James Sterling reports on renewable energy developments, climate policy, ecological conservation, and green tech innovations around the globe.