Exclusive Provider Organization (EPO)

An Exclusive Provider Organization (EPO) is a type of managed health plan that utilizes a network of providers exclusive to the plan. This means that if you are enrolled in an EPO, you are required to see doctors or specialists that have signed an agreement to take the EPO’s designated insured. Unlike a PPO plan, where there is flexibility to see any provider, with an EPO the provider selection is limited. The advantage of an EPO plan is that it is cheaper than a PPO due to the limited networks of providers. Enrollees will have to pay out-of-pocket if utilizing a provider outside the EPO's designated network. Additionally, EPO plans usually have no out-of-network coverage and will not cover referrals to other medical labs or specialists.