A PPO (or “preferred provider organization”) is a health plan with a “preferred” network of providers in your area. You do not need to select a primary care physician and you do not need referrals to see a specialist. ... An EPO (or “exclusive provider organization”) is a bit like a hybrid of an HMO and a PPO .
Does PPO cover more than EPO?
What is a PPO? A PPO, or Preferred Provider Organization, is a type of health plan that offers a larger network so you have more doctors and hospitals to choose from. Your out-of-pocket costs are usually higher with a PPO than with an HMO or EPO plan .
Is it better to have an EPO or PPO?
A PPO plan gives you more flexibility than an EPO by allowing you to attend out-of-network providers. On the other hand, an EPO will typically have lower monthly premiums than a PPO. But, if you're considering an EPO, you should check approved in-network providers in your area before you decide.
Are EPO Plans Bad?
Another major disadvantage of EPO insurance is the inability to see out of network healthcare providers without being responsible for all medical fees . In short, if you are looking for low monthly premiums and are willing to make higher deductibles for healthcare you need, you may want to consider EPO health insurance.
Why is my EPO more expensive than PPO?
Since you do have a restriction of using an exclusive network with the EPO plan, it is often cheaper than a PPO plan , making it an excellent compromise for those looking to have more control over their healthcare without paying significantly more in insurance premiums.
What is PPO good for?
More flexibility
Unlike an HMO, a PPO offers you the freedom to receive care from any provider— in or out of your network. This means you can see any doctor or specialist, or use any hospital. In addition, PPO plans do not require you to choose a primary care physician (PCP) and do not require referrals.
What is the difference between Blue Cross Blue Shield EPO and PPO?
A PPO (or “preferred provider organization”) is a health plan with a “preferred” network of providers in your area. ... An EPO (or “exclusive provider organization”) is a bit like a hybrid of an HMO and a PPO. EPOs generally offer a little more flexibility than an HMO and are generally a bit less pricey than a PPO.
Are EPO plans good?
EPO health plans generally have lower monthly premiums, co-pays, and deductibles than non-EPO options. ... If you want the freedom to schedule appointments directly with specialists, and do not mind having to switch health care providers to one in your EPO network, then EPOs may be a good choice for you.
Do doctors prefer HMO or PPO?
In general, PPO networks tend to be broader , including more doctors and hospitals than HMO plans, giving you more choice. However, networks will differ from insurer to insurer, and plan to plan, so it's best to research each plan's network before you decide.
What kind of insurance is EPO?
Exclusive Provider Organization (EPO) Plan. A managed care plan where services are covered only if you go to doctors, specialists, or hospitals in the plan's network (except in an emergency).
Do EPO plans have a deductible?
The deductible is a specified annual dollar amount you must pay for covered medical services before the plan begins to pay benefits. EPO deductibles are flat amounts , as shown on the Key Provisions chart.
What are the benefits of an EPO?
- Lower Rates. EPO insurance rates are generally lower than other types of health plans. ...
- Direct Access to In-Network Specialists. If you have employees with chronic health conditions, EPO insurance can be highly beneficial. ...
- PCPs Are Not Required. ...
- Emergency Coverage.
How does EPO insurance work?
Exclusive Provider Organization (EPO) health plans offer a local network of providers and hospitals from which members can choose to receive care . EPOs generally have lower monthly premiums than PPO plans but members cannot receive covered care outside of their plan's work with the exception of an emergency.
Do EPO plans require referrals?
An EPO (or “exclusive provider network”) is a bit like a hybrid of an HMO and a PPO. ... Like a PPO, you do not need a referral to get care from a specialist . But like an HMO, you are responsible for paying out-of-pocket if you seek care from a doctor outside your plan's network.
What is Blue Cross EPO plan?
EPO Plans (Non-Marketed)
Exclusive provider organization (EPO) plans give members access to network providers in our Full PPO or Tandem PPO network . Members have the flexibility to see any network doctors and specialists without a referral. Except for emergencies, EPO plans have no out-of-network benefits.
Whats better PPO or HMO?
The biggest advantage that PPO plans offer over HMO plans is flexibility. PPOs offer participants much more choice for choosing when and where they seek health care. The most significant disadvantage for a PPO plan, compared to an HMO, is the price. PPO plans generally come with a higher monthly premium than HMOs.
