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
Related guide
→ US Guide: how us health insurance worksSources
Last reviewed: September 2026