What is an EPO? (Exclusive Provider Organization)

A type of managed care health insurance, EPO stands for exclusive provider organization. EPO health insurance got this name because you have to get your health care exclusively from healthcare providers the EPO contracts with, or the EPO won’t pay for the care. As is the case with other health plans that require you to stay within their provider networks, EPOs will pay for out-of-network care in emergency situations.

Like their cousins, PPOs and HMOs, EPO health plans have cost-containment rules about how you get your health care. If you don’t follow your EPO’s rules when you get healthcare services, it won't pay for the care.