Difference between PPO and EPO

PPO vs EPO

What is Difference between PPO and EPO? There are many types of insurance created around the world to treat and ensure that people get medical treatments at a reasonable price. It is difficult to predict when we will get sick and therefore know when we will need medical attention and therefore it is important to be insured. However, due to the wide variety of options available, trying to clarify which is the best option is not a simple task. Take for example the PPO and EPO insurance systems in the United States. Below this post is all about the difference between PPO and EPO.

Difference between PPO and EPO

Definition:

  • PPO stands for Preferred Provider Organization or Preferred Provider Option (preferred provider organization or preferred provider option)
  • EPO stands for Exclusive Provider Organization (Exclusive Provider Organization)

Technical Differences

A PPO is directed by doctors, health providers and other health care organizations that take out the insurance of the clients and provides them with the insurance policy through a third organization. An EPO provides the same type of insurance plan however on a smaller scale; the providers that work with them offer a larger amount of discounts for their services.

What does it mean for the Patient?

In the case of a PPO, people are more flexible when it comes to choosing their GP. They do not need to contact their doctor to schedule an appointment with the specialist doctor. Charges for premium insurance is higher than with an EPO, however it is by a very small margin.

With an EPO, the company will choose the primary care physician and the patient will have to follow their advice and instructions. It is only when the specific doctor agrees to some type of treatment that the insurance will cover. The charges are not negotiable and if you decide to stop the insurance process you will have to pay the receipts that the company has pending with you.

There are very small differences between these two systems and it becomes extremely difficult for people to really understand the true meaning of both insurance systems, however, it is very important to study their differences.

In Summary:

  • A PPO and EPO are medical insurances that are managed by a third party or organization.
  • A PPO has a broad network of professional providers that operate with their own rules and regulations.
  • An EPO is a much smaller network and does not have a wide variety of health care providers.
  • The payment of the PPO insurance is a little higher than the EPO insurance.
Updated: December 15, 2017 — 7:01 am
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