Difference Between HMO And EPO

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Difference Between HMO And EPO. In this article, you will read about what is HMO, what is EPO, and what is the main difference between HMO and EPO. Both the terms are related to each other, but have significant differences between them. Here, we will first understand the main difference between HMO and EPO, then differentiate between them in detail.

In US and many other foreign countries, a citizen is given an insurance plan to receive medical treatment by consulting doctors and various specialists. These insurance plans are pretty expensive. But, the government provides various types of plans, so an individual can choose the health insurance plan according to their needs. The plans may differ in terms of cost, size of the plan network, coverage of out-of-network services, availability of specialists.

There are three types of health insurance plans, i.e. HMO, PPO, and EPO. In this piece of information, we will discuss HMO and EPO.

What Is The Main Difference Between HMO And EPO?

The main difference between HMO and EPO is that the:

HMO stands for ‘Health Maintenance Organization’. It is a health insurance plan that provides hospitals, doctors and specialists within the local network. It is less expensive.

-EPO stands for ‘Exclusive Provider Organization’. It is a health insurance plan the provides hospitals, doctors and specialists within the network, but the network is larger than the HMO’s plan. You have an option to select specialists and doctors out-of-network with extra cost.

Difference Between HMO And EPO - chart

What Is HMO?

HMO stands for ‘Health Maintenance Organization’. It is a health insurance plan that provides hospitals, doctors and specialists within the local network. It is less expensive. The doctors and specialists working under this insurance plan have agreed to lower their charges without any reduction in their services. It provides very few opportunities to the patients out-of-network.

In HMO, if a patient wants to see a doctor that is out-of-network, he has to pay the extra fees for the entire visit. There are some other conditions, which the patient has to follow in HMO. There is a registration required with PCP (primary care physician). He will determine the treatment that is needed and also refer to the special test and visits.

HMO plan is the best for those, who are less financially capable or are concerned about costs.

What Is EPO?

EPO stands for ‘Exclusive Provider Organization’. It is a health insurance plan the provides hospitals, doctors and specialists within the network, but the network is larger than the HMO’s plan. You have an option to select specialists and doctors out-of-network only in an emergency.

No referral is required from a primary care physician. It is a pocket-friendly insurance plan. You can avail some high facilities by keeping your pocket in the budget.

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