What does the acronym "EPO" stand for in health insurance?

The acronym "EPO" stands for Exclusive Provider Organization in health insurance. An EPO is a type of managed care plan that provides coverage to members only if they use a network of doctors and hospitals that have contracted with the EPO. This means that outside of emergencies, members must seek care from providers within this network to have their medical expenses covered.

EPOs typically offer lower premiums and deductible amounts compared to other types of health insurance plans, such as PPOs (Preferred Provider Organizations) or HMOs (Health Maintenance Organizations). However, the limitation to network providers can be a significant factor for consumers when selecting a health plan, as it offers less flexibility in choosing healthcare providers.

Understanding the structure of EPO plans is crucial, as it affects how members access care and their financial responsibilities. Knowing this can help prospective policyholders make informed decisions about their health insurance options and choose a plan that aligns with their healthcare needs and preferences.