Difference Between PPO and EPO

PPO vs EPO

There are many insurance systems created all over the world to try and make sure that people get their medical treatments at very reasonable rates. It is difficult to predict when you are going to get sick and when you are going to need medical attention, and it is therefore very important to be properly insured. However, due to the overwhelming possibilities available, trying to figure out which one is the best, and how they function, is not easy. For example, let’s look at the systems in the United States – the PPO and EPO insurances.

Definition

 PPO stands for Preferred Provider Organization, or Preferred Provider Option.

EPO stands for Exclusive Provider Organization.

Technical Differences

 A Preferred Provider Organization is run by Medical Doctors, Medical Health providers and other health care organizations that take an insurance premium from the customers and provides them with an insurance policy through a third party organization.

An Exclusive Provider Organization provides the same kind of insurance plans, however, on a smaller scale. The providers that work with them offer larger amounts of discount for their services.

What does it mean for the patient?

 In the case of a Preferred Provider Organization, people have more flexibility when it comes to choosing the primary care doctor of their choice. Also, they do not need to contact their doctor to get an appointment with a specialist health provider. The fees for the insurance premium is higher than that of the EPO, however, it is only by a very limited margin.

With an Exclusive Provider Organization the company will choose the primary health care provider for you, and you will have to follow his advice and instructions. It is only when that specific doctor agrees to some kind of treatment that you will be able to get the insurance necessary. The fees are not negotiable, and if you decide to stop the insurance process you will have to pay all the pending bills that the company may have with you.

There is very little difference between the two systems, and it becomes extremely difficult for people to really understand the real meaning of the two of them, however, it is important to study their differences properly.

Summary:

1. A PPO and EPO are medical insurances that are being run by a third party, or an organization.

2. PPO has a vast network of professional providers that function as per their rules and regulations.

3. EPO is a much smaller network, and it does not have so many health care providers.

4. The fee of a PPO insurance is slightly higher than that of an EPO insurance.

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