What the h-e-double-hockey-sticks is an EPO?

what is an epo in health insurance

Welcome to the EPO Club

Most health insurance companies nowadays offer some type of EPO

As a member of an EPO, you can use the doctors and hospitals within the EPO network, but cannot go outside the network of care. There are no out-of-network benefits." class="glossaryLink ">EPO or limited network Plan

A benefit your employer, union or other group sponsor provides to you to pay for your healthcare services." class="glossaryLink ">plan as a way to keep costs down. But there is a science behind who is invited to the “EPO

As a member of an EPO, you can use the doctors and hospitals within the EPO network, but cannot go outside the network of care. There are no out-of-network benefits." class="glossaryLink ">EPO Club.”

The way a physician or hospital makes it into the EPO

As a member of an EPO, you can use the doctors and hospitals within the EPO network, but cannot go outside the network of care. There are no out-of-network benefits." class="glossaryLink ">EPO club (or network ) is by achieving excellent medical outcomes. This means they have a good track record for delivering effective and cost efficient healthcare (service that works for you and costs everyone less). If you are healthy, you spend less money on health care. So it makes sense that insurers would want to use doctors that do a better job at getting and keeping you healthy.

Of course, not all members are in perfect health. The truth is that people get sick, and healthcare is expensive.

How It Really Works

As a member of an EPO, you can use the doctors and hospitals within the EPO network, but

cannot go outside the network of care. There are no out-of-network benefits." class="glossaryLink ">EPO networks have a proven record of providing quality, efficient healthcare to members. #nocrazydocs

When you have sick members (which every insurance company does), medical outcomes become really important. As a health insurance company, we want to do our best to make sure that the care our members receive is doing what it’s supposed to be doing: medications are working, members have clear instructions on how to take care of themselves after surgery, and things like that. These are things that keep everyone’s costs lower, because when a patient knows how take care of themselves, they are less likely to end up in the emergency room or hospital with a problem that could have been avoided.

Reducing costs (especially for things that could have been avoided) means we are able to charge less for an insurance policy. Lower-cost insurance policies means we not only keep our members, but attract new members, which means more people have access to better healthcare .

So really, having an EPO

As a member of an EPO, you can use the doctors and hospitals within the EPO network, but cannot go outside the network of care. There are no out-of-network benefits." class="glossaryLink ">EPO Plan

A benefit your employer, union or other group sponsor provides to you to pay for your healthcare services." class="glossaryLink ">plan doesn’t mean that your health insurance company is trying to be a cheapskate and strong-arm you into seeing a doctor that practices out of his pickup truck. That’s not it at all. We are really just trying to keep medical costs down by working with our EPO

Source: cohealthop.org

Category: Insurance

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