About EPO health Plan 2017

A recent study reveals quite a lot of changes in the 2017 affordable health insurance plans, be it PPO, HMO, or EPO. Exclusive Provider Organization aka EPO health plan has decreased its cost-sharing values by 19% compared to what you paid in 2016 under this plan. There have been marked variations in the prescription drugs cost sharing issues as well.

What is an EPO health plan?

EPO is the acronym for Exclusive Provider Organization, an exclusive network of doctors, hospitals and other medical facilities. Under EPO health insurance plans, you will not receive any coverage out-of-network.

Why will you look for an EPO health insurance plan?

  • When you do not need a Primary Care Provider (PCP)
  • With EPO health plans, you will receive medical attentions than with PPO or HMO plan
  • With an EPO, you receive a separate group of doctors, who are in an agreement with your health insurance providers and will provide you with medical facilities at much reduced rate.
  • Your insurer will bear your medical costs if you visit a physician within you EPO health plan.
  • As there is a relationship between health care providers and the insurance marketplace. It gets extremely beneficial as lower healthcare facilities mean you will pay lower monthly premiums.


No Need of PCP Must have a PCP Not necessary to have a PCP
No need for the PCP to refer to a specialist PCP must refer to a specialist Referral may or may not be received from PCP
No subsidies and insurance coverage for out-of-network medical assistance No coverage, but you may consult specialist out-of-network Out-of-network coverage and subsidies allowed in case of emergencies
Insurance provider and medical care providers collaborate There is a PCP and some in-network facilities that receive assistance from health insurance marketplace The PCP is required for both in-network and out-of-network specialist consultation.

Benefits of EPO plans

  • EPO plans are as flexible as the PPO plans and you can save money like in HMO plans
  • In EPO health insurance plans, you need not choose a PCP plus, you don’t need referrals for specialist consultation.
  • Once you are under a good EPO network, all your health anomalies will be smoothly cured at bare minimum expenses.
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