Exclusive Provider Organization (EPO)
An Exclusive Provider Organization (EPO) plan is a type of health insurance plan that combines elements of an HMO plan and a PPO plan. It does not require a Primary Care Physician (like a PPO plan), but there is no out-of-network coverage (like an HMO plan).
What makes an EPO plan unique?
- Commonly, EPOs are found in the northeastern US, where the EPO network is usually the tri-state area (but EPOs can exist elsewhere).
- EPO plans do not require a Primary Care Physician.
- EPO plans do not have out-of-network coverage (except in emergency situations), like an HMO.