An exclusive provider organization (EPO) is a type of health plan provider arrangement that has some characteristics similar to an HMO and some similar to a PPO. Providers are the doctors, specialists, and facilities that deliver medical care covered under the insurance plan. In an EPO, health plan enrollees are generally restricted to in-network providers if the care is to be covered by the insurance plan. This restriction is similar to the workings of an HMO health plan. However, like a PPO health plan, an EPO enrollee does not require the selection of a primary care physician (PCP) and the use of a PCP to obtain medical referrals for in-network care. However, unlike a PPO, out-of-network care is not available outside of specific emergency situations.
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