EPO Insurance Plans: Why You Should Consider Them

malden solutions epo insurance

An EPO stands for Exclusive Provider Organization.

When job hunting, the “what kind of salary are you looking for…” question is one of the most awkward to answer for most people. The common advice is to have a range in mind but also to remain flexible, just in case. Most people coach this idea in terms of being “flexible depending on the benefits package being offered.” This is because the benefits package that a company can offer is an important consideration for most people’s bottom line: paying for your own insurance out of your post-tax pay check is different than having it paid for automatically from your pre-tax amount, even if it is the same price in dollars and cents. And when it comes to those benefits, the supplementals ones like life insurance and identity theft protection are nice, but the biggest determiners are usually the PTO process and health insurance. Health insurance is usually looked at as a choice between HMO and PPO, but there is another option: EPO insurance. Let’s learn more.

How Is An EPO Different Than An HMO Or PPO?

Let’s start with what you may or may not already know: a PPO is an insurance plan that allows you to see both in-network and out-of-network providers with at least a portion of the cost still being covered while an HOM is an insurance program with stricter rules about staying in network and a requirement for a referral each time you see a specialist. An EPO (which stands for Exclusive Provider Organization) is sort of in the middle. While an EPO insurance plan won’t typically cover any out-of-network visits (outside of a medical emergency), there is not a requirement for a referral each time.  


What Are The Benefits Of An EPO Insurance Plan?

The major benefit of an EPO is that it falls in the middle between the other two choices. You will pay lower premiums for an EPO than for a Ppo, but you are limited to the network. This means that you trade the cost savings for the flexibility. However, you still retain some flexibility compared to an HMO, since you don’t have to go to your primary care provider and get a referral for every single specialist. This ability to see your specialist without having to wait to see your PCP first (and without having to plead your case for a referral) can be a huge benefit. Finally, an EPO doesn’t restrict you from seeing an out-of-network emergency provider, like an ER.


What Else Should You Know About EPOs?

It is important to keep in mind that the network for an EPO is typically going to be smaller than for an HMO, so your access to specialists might be limited by that.


Partner with Malden Solutions Today

Malden Solutions has a wealth of expertise in providing employer insurance solutions, HR solutions, and individual insurance solutions to businesses both big and small. Our team of seasoned professionals can help you navigate the rapidly-changing world of insurance with ease. We partner with businesses and individuals throughout the country to provide our dedicated services for employee benefits but also work within our surrounding communities in Maryland, Northern Virginia, and Washington, D.C. Contact us today to learn more about how we can provide effective, dynamic solutions for your business. Stay connected with us on Twitter, Facebook, and Linkedin.

This entry was posted on Friday, September 30th, 2022 at 1:19 pm. Both comments and pings are currently closed.