EPO refers to Exclusive Provider Organization, which is a type of dental insurance. Under this plan people can receive can get affordable dental care. Under the EPO Healthcare Plans a network of healthcare professionals including dentists partner with an insurance company to provide the policyholders with dental treatments at discounted rates. EPO healthcare plans pay for most of the cost of the member’s healthcare needs. This plan is generally an agreement between the healthcare providers and the insurance providers. The difference of the original and discounted fees will be paid by the insurance provider. It is important to know that you must go to the dentists who participate in the EPO healthcare plan to avail the benefits under this plan.
EPO healthcare plans are not recognized by the federal law of the US. Some states have made regulations to allow the EPO plan and it is not legal in many states. The first state to recognize the EPO plans is California.
The EPO healthcare plans are similar to the HMO plans as far as the discounted rates are concerned. The members can avail these reduced rates when they become members of the plan for visiting only the dentist who is part of the list approved by the insurance company. The medical care providers get more business in exchange for the reduced fees. A member of the EPO dental plan pays only for the services when they are received and it does not pay for the dental services in advance like the HMO plan. The insurance company pays a fixed amount to the dentist every month for all the participating dentists in advance. The dentist or the patient may be required to submit the claims in the EPO plan. Most of the dentists choose to do this to make sure they get paid for their services in time.
EPO healthcare plan is cheaper than PPOs and HMOs. This plan helps you save money on health insurance as it comes with a nice selection of specialist healthcare providers and sufficient emergency care options. Since it is a closed dental plan the member must visit only the dentists in the approved list. These dentists may provide basic dental services and limit the specialized services as the cost of such specialized services is very high. The drugs approved by EPO plans may not include certain drugs that you may need for treating your dental condition. The services differ with each dental service provider so you should choose the dentist carefully if your needs are covered. EPO plans do not cover experimental dental procedures as well.
When selecting your EPO healthcare plan make sure that its network of healthcare providers includes the specialists whose services you and your family may need more. It is also advisable to ensure that the emergency care options available near your home and available at affordable rates.
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