EPO
September 22, 2009A less familiar health plan is the EPO, or Exclusive Provider Organization. EPOs are very similar to PPOs (Preferred Provider Organizations) in that a group, or network, of healthcare providers contract with a health plan to provide services to those under the plan. In order to receive benefits, an insured under the plan must use providers within the network. Should an insured use an outside provider, he or she will be responsible for all related expenses. This is how an EPO differs from a PPO. A PPO will provide benefits for use of an out of network provider, however at a significantly reduced rate. In case of emergency, an EPO plan may provide benefits, but very limited benefits.
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