Networks

EPO: Exclusive Provider Organization

  1. How it works: EPOs are similar to HMOs — you have access to a specific network of care providers and there is no out-of-network coverage, except in the case of emergencies. However, you can see specialists without a primary care physician's referral.

  2. What you pay: Like HMOs, EPOs often have lower premiums than PPOs and your annual spend may be less than in a PPO, assuming you avoid out-of-network care.

  3. Is an EPO right for you? If you like the idea of a plan with a specific network of providers, but want a little more flexibility seeing specialists, EPOs can be a great option. If this type of organization is still too binding given your health needs, a PPO is likely to be the best option for you.