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What is an EPO plan? from Partner Agency Insurance Services

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What is an EPO plan?

Oct 22, 2014

What are the benefits of an EPO plan? Is this plan a good choice for me?

What are the benefits of an EPO plan? Is this plan a good choice for me?

What is an EPO plan or an EPO Network?

Many people are aware of HMO or PPO plans, but many carriers, such as Anthem Blue Cross, are now offering EPO plans. EPO stands for “Exclusive Provider Organization” and is a new affordable choice in health care. These EPO plans are made affordable through exclusive partnerships between EPO carriers and premier doctors and hospitals.

What are some of the partnerships developed with EPO plans?

Anthem Blue Cross has developed EPO relationships with many premier hospitals in California including: Ronald Reagan UCLA Medical Center and Cedars-Sinai Medical Center in Los Angeles, Sharp Memorial Hospital in San Diego, and UCSF Medical Center in San Francisco.

How do I benefit from an EPO plan?

Members of EPO plans have the flexibility to visit any doctor within the EPO network or the Pathway Providers PPO network. There is no need to choose a primary care physician or get a referral to see an in-network specialist; you can contact the doctors you wish to visit directly to make an appointment. This will save you the time, money, and hassle of receiving medical referrals.

EPO plans are ideal for clients who are concerned about the cost of healthcare. EPO plans are built through exclusive relationships between doctors and hospitals that are committed to keeping the costs of health care down.

Can I go to a doctor out of network if I have an EPO plan?

In general, out of network care is NOT covered in an EPO plan, though there are certain exceptions made for emergency or urgent care.

Have questions?

Partner Agency can provide you with professional expertise in understanding your health care options, and guide you through the application and eligibility process. We can offer you affordable health care coverage through Covered California or directly with medical insurance carriers for Individuals & Families or Employer Group coverage for groups of any size. Please feel free to contact us for a complimentary quote from various companies for almost any kind of insurance at (714)482-9500.

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