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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.
EPOs may be a solid choice for healthy employees—particularly young ones—who only go to the doctor on occasion or who are worried about running into emergency health care costs one day. Key ...
In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...
eHealth, Inc., doing business as eHealthInsurance, is a publicly traded online marketplace for health insurance, organized in Delaware and based in Santa Clara, California. The company primarily provides plans related to Medicare such as prescription drug plans, Medigap, and Medicare Advantage plans.
A surgeon in Austin, Texas, was in the operating room with a patient when a call came in from the patient’s insurance provider, UnitedHealthcare. She returned the call and shared the story.
GEHA (Government Employees Health Association) is a self-insured, not-for-profit association providing medical and dental plans to federal employees and retirees and their families through the Federal Employees Health Benefits program and the Federal Employees Dental and Vision Insurance Program (FEDVIP).
The following 3 states are Partnership Marketplaces. In Partnership Marketplaces, states retain certain essential functionality for operating an insurance marketplace. Arkansas; Georgia; Oregon; State-Based Marketplaces (SBM) Manage Marketplace functions, but rely on Healthcare.gov platform to manage their eligibility and enrollment functions.
The Knox-Keene Health Care Service Plan Act of 1975 is a set of Californian laws that regulate Healthcare Service Plans. Under these laws, pharmacy benefit managers with contracts to Health care service plans are required by law to be registered with the Department of Managed Health Care to disclose information. [58] SB 966: Pharmacy benefits