US Medical Term · insurance
EPO (Exclusive Provider Organization)
Organización de Proveedores Exclusivos
In 9 languages
| Language | Term |
|---|---|
| English | EPO (Exclusive Provider Organization) |
| Spanish (Español) | Organización de Proveedores Exclusivos |
| Chinese (中文) | 专属医疗提供者组织 |
| Korean (한국어) | 독점 의료 공급자 조직 |
| Vietnamese (Tiếng Việt) | Tổ chức nhà cung cấp độc quyền |
| Filipino (Tagalog) | EPO |
| Portuguese (Português) | Organização de Provedores Exclusivos |
| Thai (ภาษาไทย) | องค์กรผู้ให้บริการเฉพาะ |
| Japanese (日本語) | EPO（専属医療機関組織） |
What it means
An EPO (Exclusive Provider Organization) combines features of HMO and PPO plans. Like an HMO, it typically does not cover out-of-network care (except emergencies), but like a PPO, it usually does not require referrals to see specialists. Members must use the plan's network of providers for all non-emergency care. EPOs often have premiums between HMO and PPO levels. They are increasingly common in ACA marketplace plans.
How to say it
Sentences a patient might use with a doctor, nurse, pharmacist, or insurer:
I have an EPO plan, so I cannot see doctors outside the network, correct?
Tengo un plan EPO, así que no puedo ver médicos fuera de la red, ¿correcto?
My EPO does not require a referral to see a specialist, so can I call directly?
Mi EPO no requiere una derivación para ver a un especialista, ¿puedo llamar directamente?
Since EPO plans do not cover out-of-network care, I need to find an in-network cardiologist.
Como los planes EPO no cubren atención fuera de la red, necesito encontrar un cardiólogo dentro de la red.
Where you'll see it
Related terms
All terms in this area: Insurance and billing — Seguro médico y facturación
Related guide
→ US Guide: how us health insurance worksSources
Last reviewed: September 2026