Medical Insurance Comparison
When you are seeking health insurance coverage you can routinely find information about Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs). To add to your list of choices and options in the health care industry, the latest offering includes Exclusive Provider Organization Plans. Basically, an Exclusive Provider Organization (EPO) plan has some characteristics of both HMOs and PPOs. For a medical insurance comparison, with an EPO plan you will have a network of health care providers, and you are not allowed to go to a provider outside of the network unless you are prepared to pay the full cost of service, which functions like a HMO. Whereas with a PPO plan you can go to a service provider outside of your network and some portion of the costs will still be covered. Also, total administrative costs of EPO plans are much cheaper than those for comparable HMO plans, the only cost involved is the cost to process claims.
Under an HMO plan the medical providers will generally be paid a monthly amount per beneficiary, whereas with an EPO plan the medical providers are only reimbursed for the services they provide, which sounds like a much more efficient organization. In some situations EPO plans have less minimum benefit requirements than comparable HMO plans which is another cost saving benefit of EPO plans. Finally, some insurers have found that EPOs are economical and fairly easy to start when compared with HMOs.
One major advantage is you do not need to obtain a license from a state's insurance department, which saves time and money, you need only to go through a credentialing process. Additionally, EPOs are not subject to premium taxes as are HMOs. Whatever your choice is for a health care plan, there are many options available depending on what your specific needs are.