EPO plans are a hybrid: like PPO, no referrals required and you can see any in-network specialist. But like HMO, there's no out-of-network coverage (except emergencies). Often priced between HMO and PPO.
Typical cost
$340-$640/month for a single 40-year-old on a Silver EPO.
How EPO plans work
- 01
No PCP required.
- 02
See any in-network specialist directly.
- 03
Out-of-network care not covered.
- 04
Premiums between HMO and PPO.
Pros
- • No referrals
- • Cheaper than PPO
- • Larger network than typical HMO
Cons
- • Strict in-network requirement
- • Limited out-of-state coverage
Best for
- Buyers who don't need out-of-network coverage but want specialist freedom