Exclusive Provider Organization Insurance — Affordable Coverage, In Network
EPO is short for Exclusive Provider Organization.
EPO Plans in Washington State
An EPO plan offers health care services through a network of pharmacies, doctors and hospitals. EPOs are in-network-only plans that do not offer coverage out of network except in emergency situations. EPOs plans usually do not require you to get referrals for specialists.
How to use an EPO plan
EPOs cover a wide range of healthcare services. To use your EPO coverage you’ll need to select a primary care physician (PCP). Typically, the list of approved providers includes GPs, internists, pediatricians, and DOs and others. If you needed to see a specialist, you typically do not need a referral and can schedule the appointment. Depending on the health insurance plan you choose you could pay a copay for your office visit or it may be subject to the deductible. Remember to use in-network providers as EPOs only cover out-of-network providers in emergency situations.
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All you pay for is the premiums, which are the same with or without our help.
EPO Insurance Plan FAQs
What is the difference between PPO and EPO?
The primary difference is out-of-network benefits. EPOs do not have out-of-network benefits. Preferred Provider Organizations (PPOs) allow you to go in or out of the network.
What is the difference between HMO and EPO?
Both EPOs and HMOs do not have out-of-network benefits. The primary difference between the two is referrals. EPOs typically do not require referrals for specialists. HMOs require referrals.