HMO Vs PPO+ Beyond: Assessing The Different Types Of Health Insurance Plans

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Exclusive Provider Organization (EPO)

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An EPO is sort of an interesting hybrid of an HMO and a PPO. It will usually require you to stick with in-network provider (besides emergency visits), but that network will usually be larger than that of an HMO. PCP referrals might be required to see a specialist, but they might not be.

The premiums are relatively affordable – they’re often higher than that of an HMO but less than that of a PPO. Deductibles will be higher than an HMO.

Pros: Large network of providers. PCP referrals might not be required.

Cons: Deductibles are slighter higher than that of HMO.

Who is it good for? An EPO is a smart plan for people who regularly need to see a specialist and who travel often. These individuals need access to a large national network of providers and need the freedom to see specialists without PCP referrals.

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