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You are here: GroupsiBusinessHMO And EPO: Find The More Suitable Plan For You
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  • Created 17 Aug, 2016

Whether you are one of those people who were born with the wrong set of allergens, or just one of those who are concerned about their health more than anything, knowing your way around insurance offers is an important knowledge. Learning about what health insurance offers are out there is very important since it may determine what plans you may want to get. Aside from that, if you are the type of person to regularly visit health care providers, these health insurances may actually help you a lot, even financially.

Two of the health insurance plans you may want to consider getting are the HMO and the EPO. HMO vs. EPO are two health plans are closely related in terms of benefits but have key differences which you can use to determine what plan may suit your needs the best.

HMO

An HMO or Health Maintenance Organization health insurance plan restricts you to approaching only the doctors in the network given by the offer. Also, in an HMO plan, you are compelled to see a primary care doctor for any health problems whom will issue a referral letter if you need to see a specialist. The specialist whom you will be referred to must also be a part of the HMO network. In line with all these, choosing to see doctors and specialists outside of the network will mean that the bill will solely be on you.

EPO

On the other hand, while HMO restricts you to a specific network, an EPO or Exclusive Provider Organization health insurance plan allows you to visit any doctor or hospital without any referrals from a primary care doctor in the network. However, although the EPO plan will offer you a wider array of choices as compared to the HMO, choosing to go out of the network will merit to zero reimbursement much like the case in choosing an HMO insurance plan.

To sum it all up, an HMO or Health Maintenance Organization plan will have you restricted to a given network of doctors and health care professionals while in an EPO or Exclusive Provider Organization plan will give you a wider choice since you can also visit other professionals without the approval or referral of an in-network doctor. For those who prefer to have one doctor or one network to coordinate processes, an HMO might be the most suitable plan for you. However, for those who want to explore their options and want to visit other professionals without having to go through referrals, the EPO may be better.