What Is EPO Medical Insurance?

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EPO stands for exclusive provider organization. Find out about EPO medical insurance with help from an insurance broker in this free video clip.

Part of the Video Series: Personal & Health Insurance Tips
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Video Transcript

Hi, my name is Susan Combs, and I'm an insurance broker with Combs and Company. Today, we're going to talk about EPO medical insurance. What an EPO stands for is Exclusive Provider Organization. What that means is that it is an in network only health insurance plan so you need to make sure that you are going to a doctor that has a contract with that insurance carrier. Another thing with an EPO is that there is no gatekeeper so what that translates to is you don't have to have any referrals and what that means in layman's terms is that if you want to go to a specialist you don't have to go to your primary care physician and get a referral from them in order to see that specialist. As long as that specialist has a contract with the insurance carrier, you can just go to them and pay a co-pay as normal. So the thing to remember is with on EPO sense it is in network only. If you go to an out of network doctor, nothing will be paid out. So it's very important to do a doctor search, go to the insurance carrier's website that you are considering and make sure that you check all your doctors or if you don't have any doctors in place, you do a search with them and go to somebody that takes that insurance so that you don't have any surprises in the end.


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