What is the Exclusive Provider Organization (EPO)?
An Exclusive Provider Organization denotes a health plan type that comes under a Preferred Provider Organization (PPO) and a Health Maintenance Organization (HMO). In an EPO, members get coverage only for in-network services, but they don’t have to pick a primary care physician (PCP) or get referrals for specialists. EPO plans work with hospitals and doctors to provide care to members, known as in-network providers or network providers. Members are covered only for services from in-network providers, and emergency care is covered regardless of network location. EPO plans usually have lower premiums compared to PPOs, but they may have a smaller network of providers.