Does MinuteClinic Accept EPO Plans?
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Does MinuteClinic accept EPO health insurance plans?
Yes, MinuteClinic accepts most forms of health insurance, including EPO plans. But as with any health plan, the specific services your EPO plan covers will vary from company to company. That’s why we recommend that you confirm your coverage before your visit. You can do this by contacting your insurance company. This will also prepare you in case there are any out-of-pocket costs like co-pays and deductibles. You can also find more information on coverage at MinuteClinic on our Insurance and Pricing page.
What is an EPO plan?
“EPO” is short for “Exclusive Provider Organization.” An EPO plan is one form of health insurance. With an EPO plan, you can use doctors and hospitals within a specific network of providers. However, EPO plans do not allow you to go to a doctor or health care facility outside of that network.
EPO plans may also:
- Require you to choose a PCP (primary care physician)
- Have a large EPO network (compared to other types of plans)
- Not require referrals from your PCP if you need to see a specialist
What are some of the characteristics of an EPO plan?
EPOs plan can simplify the process of seeing a specialist for ongoing care. That’s because EPO plans allow for easy access to specialists within their network of providers. If you have an EPO plan, you typically will not need a referral to see a specialist. This type of plan may also offer lower premiums (the monthly fee you pay for health insurance) compared to other types of plans.
What's the difference between an EPO and PPO plan?
EPO and PPO plans are similar in many ways, but there are some distinct differences. One similarity is that both types of plans have in-network providers. Your health insurance company prefers that you use these in-network providers whether you have an EPO or PPO plan. The difference is that PPO plans will allow you to see out-of-network providers. Under a PPO plan, your insurance company will likely cover some of the costs of going to an out-of-network provider. They may even cover costs for a provider outside of your home state. With an EPO plan, you can only see in-network providers. If you see a provider outside your EPO network, the insurance company will not cover any costs.
This comparatively limited access to providers can sometimes mean that EPO plans cost less than PPO plans. With an EPO plan, you also won't need a referral to see a specialist.
What's the difference between an EPO and HMO plan?
An HMO plan requires you to select a primary care physician to receive preventative and regular care. If you need a specialist, your PCP must refer you under an HMO plan. An EPO plan does not require referrals, which makes it a more flexible option. HMO plans also require all referrals to be within your specific network. Any doctors you see outside the network without a referral may require you to pay all the costs yourself unless it's an emergency. HMO plans use local networks, while EPO plans allow you to choose specialists in a broader range. EPO premiums also tend to be higher than HMO plans but are often lower than PPO plans.
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References used as sources for this page:
- EPO Health Insurance Plans - Exclusive Provider Organization. Available at: https://www.ehealthinsurance.com/health-plans/epo
(Accessed October 19, 2021) - What are the differences between HMO, PPO, EPO, and POS Plans? - Stride Health. Available at: https://support.stridehealth.com/hc/en-us/articles/201675270-What-are-the-differences-between-HMO-PPO-EPO-and-POS-plans- (Accessed October 19, 2021)