Is an EPO Insurance Plan Right For Me?

EPO stands for “Exclusive Provider Organization.” An EPO is a type of health insurance plan that offers a local network of doctors, specialists, and hospitals in your area for you to choose from. These plans are among the most affordable options with generally low monthly rates and many of the plans contain co-pays before the deductible.

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What is an EPO Health Insurance Plan?

EPO Health Insurance Plans: Understanding Your Options

It’s important to note that those with an EPO plan have health insurance coverage only for in-network doctors and hospitals, and there are no out-of-network benefits (except for emergencies). For that reason, an EPO health insurance plan may be well-suited for those whose doctor is either part of their plan’s network or for those who don’t mind switching to another doctor. It may also be for those who enjoy the idea of not having to get a referral to see a specialist. Keep in mind, however, you’d have to stay within the EPO’s network.

Alternatives to EPO Health Insurance Plans

In addition to EPO plans, you may also choose from HMO (Health Maintenance Organization plans), or PPO (Preferred Provider Organization plans). HMO plans generally require you to see your primary doctor before seeing a specialist and they have a local network of doctors and hospitals. PPO plans generally offer larger networks, giving you more doctors and hospitals to choose from. In most cases, these plans can have slightly higher premiums than the EPO plans. It is recommended to get quotes from both types of plans.

Is an EPO Health Insurance Plan Right for You?

If you’re considering an EPO plan, it’s important that you carefully read the coverage terms and fine print of the plan. EPO health insurance plans are an attractive option for many because they have relatively lower monthly premiums. In general, EPO plans may be a good option for those who want the freedom to schedule appointments directly with specialists and don’t mind the possibility of switching to a healthcare provider that is covered by their network. Look for plans that have more “1st dollar benefits” meaning, co-pays BEFORE the deductible. Not all plans are built the same. Some EPO plans will have a higher deductible but give you lower co-pays. Some will have lower deductibles and give you higher co-pays. Some EPO plans may have HSA (Health Savings Account) plans, which are health insurance plans where you can open a separate bank account and place money into this account using pre-tax dollars to pay your medical expenses with. These plans, however, generally do not have any co-pays until the deductible has been met but do offer a tax savings if used correctly.

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Nevada Insurance Enrollment Can Help

Unfortunately, insurance company’s use a variety of coverage terms that are often riddled with industry verbiage that can be difficult to decipher. At Nevada Insurance Enrollment, our health insurance agents specialize in helping our members understand their options. To learn more about EPO plans or to apply for health insurance, contact one of our health insurance agents today. At Nevada Insurance Enrollment, we can review your health history and help you find a plan that will fit your needs, lifestyle, and budget.

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♦ What Is The Difference Between An HMO And A PPO?

♦ Things Potentially NOT Covered By Your Health Insurance


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