You’re probably familiar PPO’s (Preferred Provider Organizations) and HMO’s (Health Maintenance Organizations) – but what the difference between an HMO, a PPO and an EPO?
You cannot go outside the plan’s network (except for emergencies) and you need a referral from your primary doctor to see a specialist.
You can go outside the plan’s provider network, but you’ll pay a lot more. Out-of-network, your deductible and maximum out-of-pocket is usually double what it is in-network
You cannot go outside the plan’s network (except for emergencies). But like a PPO, you do not need a referral to see a specialist.
If you get an EPO, just be sure your providers are in network or that you’re saving enough to pay cash for an occasional out-of-network doctor visit.
Author: neil steinman
Neil Steinman is the principal of Orange County Health & Life Insurance in Orange County, CA – and has been serving the needs of California residents for nearly 20 years.