What Is an EPO?

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. Many plans contain co-pays before the deductible (co-pays are your friend BEFORE the deductible).

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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, and 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 have higher premium costs than the EPO plans.

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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 be HSA plans which are health savings accounts, which generally do not have any co-pays until the deductible has been met, but also offer a tax savings.

Nevada Insurance Enrollment Can Help

There are several different types of health insurance plans, each with its own unique benefits. Among some of the most common plans are EPOs. These health insurance plans may be a good option for some Nevadans with tight budgets, but they’re not a perfect fit for everyone. EPO plans are just one of a few different types of health insurance plans. Before purchasing a plan, it’s important to read the fine print to ensure that the plan that you’re purchasing is going to provide the coverage that you need.

Unfortunately, coverage terms are often riddled with industry jargon that can be difficult to decipher. At Nevada Insurance Enrollment, our health insurance agents specialize in helping Nevada residents 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 health insurance plan that will fit your needs, lifestyle and budget.

Related Articles:

What is a Health Insurance “Co-Pay”?

What is a Health Insurance “Deductible”?

In Network or Out-of-Network?

How to choose the right Health Insurance Plan

Read More: Health Insurance in Las Vegas, Nevada

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