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Thatch details the key differences between PPO and EPO health insurance plans.
In the United States, an exclusive provider organization (EPO) is a hybrid health insurance plan in which a primary care provider is not necessary, but health care providers must be seen within a predetermined network. Out-of-network care is not provided, and visits require pre-authorization.
As insurance premiums have surged, families with employer-sponsored health care plans have paid nearly 5% of their total earnings over a 32-year period, according to a 2024 report investigating ...
[4]: 6 By 1982, 40 plans were counted and by 1983 variations such as the exclusive provider organization had arisen. [3] In the 1980s, PPOs spread in cities in the Western United States, particularly California due to favorable state laws. [3]
A POS plan uses some of the features of each of the above plans. Members of a POS plan do not make a choice about which system to use until the service is being used. In terms of using such a plan, a POS plan has levels of progressively higher patient financial participation, as the patient moves away from the more managed features of the plan.
The catch-22 associated with health insurance — even with subsidies — is that the low-cost plans that most people can afford come with outrageously high deductibles, leaving the policyholder ...
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