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Difference between HMO and EPO

Difference between HMO and EPO

If you are trying to decide between an HMO and EPO plan, it can be difficult to know which is the best choice for you. Both of these types of plans have their pros and cons, and it can be hard to decide which is the right one for your needs. In this post, we will compare and contrast HMOs and EPOs, so that you can make an informed decision about which type of plan is right for you.

What is HMO?

HMOs are a type of managed care organization. HMOs contract with medical providers, such as hospitals and doctors, to provide care for HMO members at a set price. HMO members usually pay a monthly premium, and may also be responsible for co-payments or deductibles. HMOs typically require that members use the HMO’s network of providers, except in emergency situations. HMOs may also offer additional services, such as prescription drug coverage, vision care, and dental care. HMOs vary in size and scope, but all seek to provide high-quality care at a lower cost. HMOs are one option for individuals and families seeking health insurance coverage.

What is EPO?

EPO stands for Exclusive Provider Organization. EPO health insurance plans offer restricted networks of doctors, hospitals, and other providers. EPO plans are less expensive than traditional PPO plans that have broader networks of providers. EPOs usually don’t require you to get a referral from a primary care physician in order to see a specialist. Typically, EPO plans have lower monthly premiums and higher annual deductibles than PPO plans. EPO plans may also have lifetime maximum benefits that are lower than what PPOs offer.

Difference between HMO and EPO

HMO and EPO are both types of managed healthcare plans. HMO plans are more restrictive, only covering care from in-network providers. EPO plans are less restrictive, covering care from both in-network and out-of-network providers. HMO plans typically have lower monthly premiums than EPO plans. However, HMO plans also require patients to get a referral from their primary care physician before seeing a specialist. EPO plans do not require a referral. HMO plans may also have higher out-of-pocket costs for services outside of the HMO network.


While both HMOs and EPOs have their benefits, it’s important for consumers to understand the difference between the two types of plans before signing up.

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